ABSTRACT
Objective To evaluate the diagnostic accuracy of 4 μg/mL vancomycin screening plate (4VA)for vancomycin-non-susceptible Staphylococcus aureus.Methods The diagnosis trials on 4VA for vancomycin-non-susceptible Staphylococcus aureus were searched in the databases such as PubMed(1 966 to Aug.2013),The Cochrane Library(the second phase of 2013),ISI Web of Knowledge(1 980 to Aug.2013),CNKI (1 964 to Aug.2013),VIP (1 989 to Aug.2013)and Wanfang(1 998 to Aug.2013),mean-while the manual.Two reviewers evaluated the quality of the included trials according to the quality assessment of diagnostic accu-racy studies,and then meta-analysis was performed using Meta-Disc 1.4 software.Results A total of 3 trials involving 974 partici-pants were included.The results of meta-analysis showed that the weighted sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio,were 0.805 [95%CI (0.047 to 0.563)],0.921 [95%CI (0.901 to 0.938)],10.804 [95%CI (5.5 1 1 to 21.181)],0.1 62 [95%CI (0.71 to 1.0)]and 69.721 [95%CI (1 1.740 to 414.06)]respectively.Conclusion 4VA for vancomycin-non-susceptible Staphylococcus aureus has a very high specificity and sensitivity,so 4VA could be used to creening plate (4VA)for vancomycin-non-susceptible Staphylococcus aureus in clinic.
ABSTRACT
Background: Staphylococcus aureus with reduced susceptibility to vancomycin or heterogeneous vancomycinintermediate S. aureus (hVISA) have become increasingly reported from various parts of the world. hVISA cannot be detected by routine test for minimal inhibitory concentration (MIC) for vancomycin. The gold standard method for detection, population analysis profiles (PAP) method, is complicated, time-consuming, expensive, and needs well-trained microbiologists. Objective: Evaluate of 2.0 McFarland Etest method, in comparison with the PAP method, for detection of hVISA in clinical specimens. Methods: All methicillin-resistant S. aureus strains from clinical specimens isolated from consecutive patients attended at King Chulalongkorn Memorial Hospital and Siriraj Hospital, Bangkok between 2006 and 2007 were studied. 1 hundred nineteen specimens were obtained. The PAP method detected six hVISA strains 5 from blood and from cultures) from four patients at King Chulalongkorn Memorial Hospital, accounting for a prevalence of 6.35%. The MIC determined by agar dilution method was in the range of 2-3 μg/mL. Results: 2.0 McFarland Etest method detected no false positive and five false negatives (42%), and gave a sensitivity and a specificity of 16.7% and 100%, respectively. The one-point population analysis screening method detected two false positives and 1 false negative, and gave a sensitivity of 83.3% and a specificity and 98.2%. Conclusion: The 2.0 McFarland Etest method had a very good specificity but a poor sensitivity for detecting hVISA. It may be used as an alternative method to confirm detection of hVISA.