Skip to main content
PMC home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1984 Jun;19(6):813–817. doi: 10.1128/jcm.19.6.813-817.1984

Reevaluation of the ability of the standardized disk diffusion test to detect methicillin-resistant strains of Staphylococcus aureus.

J M Boyce
PMCID: PMC271190  PMID: 6565707

Abstract

To reevaluate the ability of the disk diffusion method to detect methicillin-resistant Staphylococcus aureus, 73 such isolates from 13 cities were tested for antimicrobial susceptibility with the standardized disk diffusion test. Duplicate plates were incubated at 30 and 35 degrees C and read after 18, 24, and 48 h. After incubation at 35 degrees C for 24 h, 97% of isolates appeared resistant to methicillin, and 99% appeared resistant to oxacillin. A significantly smaller proportion of isolates appeared resistant to cephalothin (P less than 0.001) and cefamandole (P less than 0.001). Isolates from some cities had no zones of inhibition around methicillin and oxacillin disks, whereas those from other cities had measurable zones of inhibition, with light growth inside the zones. Patterns of growth around cephalothin and cefamandole disks also varied among isolates from different cities. Incubation at 30 degrees C for 24 h did not result in better detection of methicillin or oxacillin resistance. All study isolates appeared resistant to methicillin and oxacillin after 48 h of incubation at 35 degrees C. The results suggest that methicillin-resistant S. aureus strains from many areas will be detected if standardized disk diffusion tests are incubated at 35 degrees C for 24 h.

Full text

PDF
817

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. Annear D. I. The effect of temperature on resistance of Staphylococcus aureus to methicillin and some other antibioics. Med J Aust. 1968 Mar 16;1(11):444–446. [PubMed] [Google Scholar]
  3. BAUER A. W., PERRY D. M., KIRBY W. M. Single-disk antibiotic-sensitivity testing of staphylococci; an analysis of technique and results. AMA Arch Intern Med. 1959 Aug;104(2):208–216. doi: 10.1001/archinte.1959.00270080034004. [DOI] [PubMed] [Google Scholar]
  4. Barrett F. F., McGehee R. F., Jr, Finland M. Methicillin-resistant Staphylococcus aureus at Boston City Hospital. Bacteriologic and epidemiologic observations. N Engl J Med. 1968 Aug 29;279(9):441–448. doi: 10.1056/NEJM196808292790901. [DOI] [PubMed] [Google Scholar]
  5. 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]
  6. Barry A. L., Garcia F., Thrupp L. D. An improved single-disk method for testing the antibiotic susceptibility of rapidly-growing pathogens. Am J Clin Pathol. 1970 Feb;53(2):149–158. doi: 10.1093/ajcp/53.2.149. [DOI] [PubMed] [Google Scholar]
  7. Bauer A. W., Kirby W. M., Sherris J. C., Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966 Apr;45(4):493–496. [PubMed] [Google Scholar]
  8. Benner E. J., Kayser F. H. Growing clinical significance of methcillin-resistant Staphylococcus aureus. Lancet. 1968 Oct 5;2(7571):741–744. doi: 10.1016/s0140-6736(68)90947-1. [DOI] [PubMed] [Google Scholar]
  9. Boyce J. M., Causey W. A. Increasing occurrence of methicillin-resistant Staphylococcus aureus in the United States. Infect Control. 1982 Sep-Oct;3(5):377–383. doi: 10.1017/s0195941700057337. [DOI] [PubMed] [Google Scholar]
  10. Boyce J. M., White R. L., Bonner M. C., Lockwood W. R. Reliability of the MS-2 system in detecting methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 1982 Feb;15(2):220–225. doi: 10.1128/jcm.15.2.220-225.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. COURTIEU A. L., GUILLERMET F. N., LONGERAY C., MAKA G., CHABBERT Y. A. FR'EQUENCE DES STAPHYLOCOQUES PR'ESENTANT UNE R'ESISTANCE H'ET'EROG'ENE A LA M'ETHICILLINE ET L'OXACILLINE EN MILIEU HOSPITALIER. Ann Inst Pasteur (Paris) 1964 Nov;107:691–697. [PubMed] [Google Scholar]
  12. Canawati H. N., Sapico F. L., Montgomerie J. Z., Zucchero J. Temperature effect on cephalothin sensitivity of methicillin-resistant Staphylococcus aureus. Am J Clin Pathol. 1981 Mar;75(3):391–394. doi: 10.1093/ajcp/75.3.391. [DOI] [PubMed] [Google Scholar]
  13. Canawati H. N., Witte J. L., Sapico F. L. Temperature effect on the susceptibility of methicillin-resistant Staphylococcus aureus to four different cephalosporins. Antimicrob Agents Chemother. 1982 Jan;21(1):173–175. doi: 10.1128/aac.21.1.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Carlson J. R., Conley F. E., Cahall D. L. Methicillin-resistant Staphylococcus aureus susceptibility testing with Abbott MS-2 system. Antimicrob Agents Chemother. 1982 Apr;21(4):676–677. doi: 10.1128/aac.21.4.676. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Cleary T. J., Maurer D. Methicillin-resistant Staphylococcus aureus susceptibility testing by an automated system, Autobac I. Antimicrob Agents Chemother. 1978 May;13(5):837–841. doi: 10.1128/aac.13.5.837. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. 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]
  17. 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]
  18. Hallander H. O., Laurell G. Identification of cephalosporin-resistant Staphylococcus aureus with the disc diffusion method. Antimicrob Agents Chemother. 1972 May;1(5):422–426. doi: 10.1128/aac.1.5.422. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Hewitt J. H., Coe A. W., Parker M. T. The detection of methicillin resistance in Staphylococcus aureus. J Med Microbiol. 1969 Nov 4;2(4):443–456. doi: 10.1099/00222615-2-4-443. [DOI] [PubMed] [Google Scholar]
  20. Jones R. N., Edson D. C. Interlaboratory performance of disk agar diffusion and dilution antimicrobial susceptibility tests, 1979-1981. A summary of the microbiology portion of the College of American Pathologists (CAP) surveys. Am J Clin Pathol. 1982 Oct;78(4 Suppl):651–658. [PubMed] [Google Scholar]
  21. Jones R. N., Edson D. C. Special topics in antimicrobial susceptibility testing: test accuracy against methicillin-resistant Staphylococcus aureus, pneumococci, and the sensitivity of beta-lactamase methods. Am J Clin Pathol. 1983 Oct;80(4 Suppl):609–614. [PubMed] [Google Scholar]
  22. Kayser F. H. In vitro activity of cephalosporin antibiotics against Gram-positive bacteria. Postgrad Med J. 1971 Feb;47(Suppl):14–20. [PubMed] [Google Scholar]
  23. 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]
  24. Myers J. P., Linnemann C. C., Jr Bacteremia due to methicillin-resistant Staphylococcus aureus. J Infect Dis. 1982 Apr;145(4):532–536. doi: 10.1093/infdis/145.4.532. [DOI] [PubMed] [Google Scholar]
  25. O'Toole R. D., Drew W. L., Dahlgren B. J., Beaty H. N. An outbreak of methicillin-resistant Staphylococcus aureus infection. Observations in hospital and nursing home. JAMA. 1970 Jul 13;213(2):257–263. [PubMed] [Google Scholar]
  28. Plorde J. J., Sherris J. C. Staphylococcal resistance to antibiotics: origin, measurement, and epidemiology. Ann N Y Acad Sci. 1974 Jul 31;236(0):413–434. doi: 10.1111/j.1749-6632.1974.tb41507.x. [DOI] [PubMed] [Google Scholar]
  29. Richmond A. S., Simberkoff M. S., Schaefler S., Rahal J. J., Jr Resistance of Staphylococcus aureus to semisynthetic penicillins and cephalothin. J Infect Dis. 1977 Jan;135(1):108–112. doi: 10.1093/infdis/135.1.108. [DOI] [PubMed] [Google Scholar]
  30. SUTHERLAND R., ROLINSON G. N. CHARACTERISTICS OF METHICILLIN-RESISTANT STAPHYLOCOCCI. J Bacteriol. 1964 Apr;87:887–899. doi: 10.1128/jb.87.4.887-899.1964. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Schaefler S., Perry W., Jones D. Methicillin-resistant strains of Staphylococcus aureus phage type 92. Antimicrob Agents Chemother. 1979 Jan;15(1):74–80. doi: 10.1128/aac.15.1.74. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. 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]
  33. Turner G. C., Cox P. E. Resistance to cloxacillin among hospital staphylococci. J Clin Pathol. 1967 Nov;20(6):870–874. doi: 10.1136/jcp.20.6.870. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Watanakunakorn C. Treatment of infections due to methicillin-resistant Staphylococcus aureus. Ann Intern Med. 1982 Sep;97(3):376–378. doi: 10.7326/0003-4819-97-3-376. [DOI] [PubMed] [Google Scholar]

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

RESOURCES