Skip to main content
PMC home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1986 Sep;24(3):349–352. doi: 10.1128/jcm.24.3.349-352.1986

Detection of methicillin-resistant Staphylococcus epidermidis.

G L Woods, G S Hall, I Rutherford, K J Pratt, C C Knapp
PMCID: PMC268911  PMID: 3639087

Abstract

To determine whether methods suggested for detecting methicillin-resistant Staphylococcus aureus apply equally to methicillin-resistant Staphylococcus epidermidis, 135 S. epidermidis isolates were tested by the Vitek AMS gram-positive susceptibility card (Vitek Systems, Inc., Hazelwood, Mo.) and by modifications of agar screen, disk diffusion, and microdilution methods. Modifications included 24- versus 48-h incubation, unsupplemented versus 2% NaCl-supplemented broth, and standard versus direct inoculum. At 24 h, the highest number of resistant strains, 59, was detected by oxacillin (1 microgram) disk diffusion. At 48 h, three additional strains were judged resistant. With one exception, results for oxacillin disk diffusion and agar screen were equivalent at 24 and 48 h. Vitek detected 50 resistant strains. Significantly fewer resistant strains were detected at 24 h by methicillin disk diffusion (5 micrograms) and methicillin microdilution with 2% NaCl. For oxacillin microdilution, neither 2% NaCl supplementation nor the method of inoculum preparation significantly affected the results. Oxacillin microdilution with cation- rather than non-cation-supplemented broth detected significantly fewer (n = 33) resistant strains at 24 h; 51 were resistant at 48 h. To detect methicillin-resistant S. epidermidis, a direct inoculum with either 24-h oxacillin disk diffusion and reincubation of intermediate strains for an additional 24 h or 24-h oxacillin agar screen and reincubation of strains with no growth for a total of 48 h is recommended.

Full text

PDF
349

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aldridge K. E., Janney A., Sanders C. V., Marier R. L. Interlaboratory variation of antibiograms of methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains with conventional and commercial testing systems. J Clin Microbiol. 1983 Nov;18(5):1226–1236. doi: 10.1128/jcm.18.5.1226-1236.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Archer G. L. Antimicrobial susceptibility and selection of resistance among Staphylococcus epidermidis isolates recovered from patients with infections of indwelling foreign devices. Antimicrob Agents Chemother. 1978 Sep;14(3):353–359. doi: 10.1128/aac.14.3.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Archer G. L., Tenenbaum M. J. Antibiotic-resistant Staphylococcus epidermidis in patients undergoing cardiac surgery. Antimicrob Agents Chemother. 1980 Feb;17(2):269–272. doi: 10.1128/aac.17.2.269. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Barry A. L., Badal R. E. Reliability of the microdilution technic for detection of methicillin-resistant strains of staphylococcus aureus. Am J Clin Pathol. 1977 May;67(5):489–495. doi: 10.1093/ajcp/67.5.489. [DOI] [PubMed] [Google Scholar]
  5. Christensen G. D., Bisno A. L., Parisi J. T., McLaughlin B., Hester M. G., Luther R. W. Nosocomial septicemia due to multiply antibiotic-resistant Staphylococcus epidermidis. Ann Intern Med. 1982 Jan;96(1):1–10. doi: 10.7326/0003-4819-96-1-1. [DOI] [PubMed] [Google Scholar]
  6. Dillon L. K., Howe S. E. Early detection of oxacillin-resistant staphylococcal strains with hypertonic broth diluent for microdilution panels. J Clin Microbiol. 1984 Apr;19(4):473–476. doi: 10.1128/jcm.19.4.473-476.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Drew W. L., Barry A. L., O'Toole R., Sherris J. C. Reliability of the Kirby-Bauer disc diffusion method for detecting methicillin-resistant strains of Staphylococcus aureus. Appl Microbiol. 1972 Aug;24(2):240–247. doi: 10.1128/am.24.2.240-247.1972. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Ein M. E., Smith N. J., Aruffo J. F., Heerema M. S., Bradshaw M. W., Williams T. W., Jr Susceptibility and synergy studies of methicillin-resistant Staphylococcus epidermidis. Antimicrob Agents Chemother. 1979 Nov;16(5):655–659. doi: 10.1128/aac.16.5.655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Friedman L. E., Brown A. E., Miller D. R., Armstrong D. Staphylococcus epidermidis septicemia in children with leukemia and lymphoma. Am J Dis Child. 1984 Aug;138(8):715–719. doi: 10.1001/archpedi.1984.02140460007005. [DOI] [PubMed] [Google Scholar]
  10. Gill V. J., Selepak S. T., Williams E. C. Species identification and antibiotic susceptibilities of coagulase-negative staphylococci isolated from clinical specimens. J Clin Microbiol. 1983 Dec;18(6):1314–1319. doi: 10.1128/jcm.18.6.1314-1319.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Haley R. W., Hightower A. W., Khabbaz R. F., Thornsberry C., Martone W. J., Allen J. R., Hughes J. M. The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals. Possible role of the house staff-patient transfer circuit. Ann Intern Med. 1982 Sep;97(3):297–308. doi: 10.7326/0003-4819-97-3-297. [DOI] [PubMed] [Google Scholar]
  12. Hamilton-Miller J. M., Iliffe A. Antimicrobial resistance in coagulase-negative staphylococci. J Med Microbiol. 1985 Apr;19(2):217–226. doi: 10.1099/00222615-19-2-217. [DOI] [PubMed] [Google Scholar]
  13. Hansen S. L., Freedy P. K. Variation in the abilities of automated, commercial, and reference methods to detect methicillin-resistant (heteroresistant) Staphylococcus aureus. J Clin Microbiol. 1984 Sep;20(3):494–499. doi: 10.1128/jcm.20.3.494-499.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Karchmer A. W., Archer G. L., Dismukes W. E. Staphylococcus epidermidis causing prosthetic valve endocarditis: microbiologic and clinical observations as guides to therapy. Ann Intern Med. 1983 Apr;98(4):447–455. doi: 10.7326/0003-4819-98-4-447. [DOI] [PubMed] [Google Scholar]
  15. Klimek J. J., Marsik F. J., Bartlett R. C., Weir B., Shea P., Quintiliani R. Clinical, epidemiologic and bacteriologic observations of an outbreak of methicillin-resistant Staphylococcus aureus at a large community hospital. Am J Med. 1976 Sep;61(3):340–345. doi: 10.1016/0002-9343(76)90370-3. [DOI] [PubMed] [Google Scholar]
  16. Kloos W. E., Schleifer K. H. Simplified scheme for routine identification of human Staphylococcus species. J Clin Microbiol. 1975 Jan;1(1):82–88. doi: 10.1128/jcm.1.1.82-88.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lowy F. D., Chang D. S., Aning V., Williams S., Szilagyi G. Reliability of in vitro susceptibility tests for detecting coagulase-negative staphylococcal resistance to penicillinase-resistant semisynthetic penicillins. J Clin Microbiol. 1983 Nov;18(5):1122–1126. doi: 10.1128/jcm.18.5.1122-1126.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Lowy F. D., Walsh J. A., Mayers M. M., Klein R. S., Steigbigel N. H. Antibiotic activity in vitro against methicillin-resistant Staphylococcus epidermidis and therapy of an experimental infection. Antimicrob Agents Chemother. 1979 Sep;16(3):314–321. doi: 10.1128/aac.16.3.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Marsik F. J., Brake S. Species identification and susceptibility to 17 antibiotics of coagulase-negative staphylococci isolated from clinical specimens. J Clin Microbiol. 1982 Apr;15(4):640–645. doi: 10.1128/jcm.15.4.640-645.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. McDougal L. K., Thornsberry C. New recommendations for disk diffusion antimicrobial susceptibility tests for methicillin-resistant (heteroresistant) staphylococci. J Clin Microbiol. 1984 Apr;19(4):482–488. doi: 10.1128/jcm.19.4.482-488.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Ponce de Leon S., Wenzel R. P. Hospital-acquired bloodstream infections with Staphylococcus epidermidis. Review of 100 cases. Am J Med. 1984 Oct;77(4):639–644. doi: 10.1016/0002-9343(84)90354-1. [DOI] [PubMed] [Google Scholar]
  22. Scherer L. R., West K. W., Weber T. R., Kleiman M., Grosfeld J. L. Staphylococcus epidermidis sepsis in pediatric patients: clinical and therapeutic considerations. J Pediatr Surg. 1984 Aug;19(4):358–361. doi: 10.1016/s0022-3468(84)80252-3. [DOI] [PubMed] [Google Scholar]
  23. Schoenbaum S. C., Gardner P., Shillito J. Infections of cerebrospinal fluid shunts: epidemiology, clinical manifestations, and therapy. J Infect Dis. 1975 May;131(5):543–552. doi: 10.1093/infdis/131.5.543. [DOI] [PubMed] [Google Scholar]
  24. Siebert W. T., Moreland N., Williams T. W., Jr Methicillin-resistant Staphylococcus epidermidis. South Med J. 1978 Nov;71(11):1353–1355. doi: 10.1097/00007611-197811000-00011. [DOI] [PubMed] [Google Scholar]
  25. Slaughter L., Morris J. E., Starr A. Prosthetic valvular endocarditis. A 12-year review. Circulation. 1973 Jun;47(6):1319–1326. doi: 10.1161/01.cir.47.6.1319. [DOI] [PubMed] [Google Scholar]
  26. Thornsberry C., Caruthers J. Q., Baker C. N. Effect of temperature on the in vitro susceptibility of Staphylococcus aureus to penicillinase-resistant penicillins. Antimicrob Agents Chemother. 1973 Sep;4(3):263–269. doi: 10.1128/aac.4.3.263. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Thornsberry C., McDougal L. K. Successful use of broth microdilution in susceptibility tests for methicillin-resistant (heteroresistant) staphylococci. J Clin Microbiol. 1983 Nov;18(5):1084–1091. doi: 10.1128/jcm.18.5.1084-1091.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Wade J. C., Schimpff S. C., Newman K. A., Wiernik P. H. Staphylococcus epidermidis: an increasing cause of infection in patients with granulocytopenia. Ann Intern Med. 1982 Oct;97(4):503–508. doi: 10.7326/0003-4819-97-4-503. [DOI] [PubMed] [Google Scholar]
  29. Wilkinson B. J., Maxwell S., Schaus S. M. Classification and characteristics of coagulase-negative, methicillin-resistant staphylococci. J Clin Microbiol. 1980 Aug;12(2):161–166. doi: 10.1128/jcm.12.2.161-166.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Winston D. J., Dudnick D. V., Chapin M., Ho W. G., Gale R. P., Martin W. J. Coagulase-negative staphylococcal bacteremia in patients receiving immunosuppressive therapy. Arch Intern Med. 1983 Jan;143(1):32–36. [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES