TABLE 2.
Comparison of susceptibility testing methods to mecA gene analysis for 58 CoNS isolates
| Method | Medium | Incubation temp (°C) | Incubation time (h) | No. of isolates
|
Sensitivity (%) | Specificity (%) | No growth on control | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| mecA positive | mecA negative | Sa | Ia | Ra | |||||||
| Agar dilution | 0% NaCl | 30 | 24 | 27 | 27 | 41b/34c | 13b/20c | 48.1b/59.3c | 100b/85.2c | 4 | |
| 48 | 29 | 27 | 42b/36c | 14b/20c | 48.3b/62.1c | 100b/96.3c | 2 | ||||
| 35 | 24 | 29 | 28 | 43b/36c | 14b/21c | 48.3b/65.5c | 100b/92.9c | 1 | |||
| 48 | 30 | 28 | 40b/35c | 18b/23c | 60.0b/70.0c | 100b/92.9c | 0 | ||||
| 2% NaCl | 30 | 24 | 28 | 27 | 34b/31c | 21b/24c | 75.0b/85.7c | 100b/100c | 3 | ||
| 48 | 29 | 28 | 34b/32c | 23b/25c | 79.3b/86.2c | 100b/100c | 1 | ||||
| 35 | 24 | 30 | 28 | 39b/35c | 19b/23c | 63.3b/76.7c | 100b/100c | 0 | |||
| 48 | 30 | 28 | 35b/30c | 23b/28c | 76.7b/93.3c | 100b/100c | 0 | ||||
| 4% NaCl | 30 | 24 | 26 | 26 | 28b/27c | 24b/25c | 92.3b/92.3c | 100b/96.1c | 6 | ||
| 48 | 29 | 28 | 32b/31c | 25b/26c | 86.2b/86.2c | 100b/96.4c | 1 | ||||
| 35 | 24 | 29 | 27 | 31b/30c | 25b/26c | 86.2b/89.7c | 100b/100c | 2 | |||
| 48 | 30 | 28 | 28b/28c | 28b/30c | 96.7bd/96.7c | 96.4bd/96.4c | 0 | ||||
| Disk diffusion | Difco | 35 | 24 | 29 | 27 | 22 | 6 | 28 | 90.0 | 74.1 | 2 |
| 48 | 30 | 27 | 20 | 4 | 33 | 93.3 | 66.7 | 1 | |||
| BBL | 35 | 24 | 29 | 27 | 23 | 2 | 31 | 86.2 | 74.1 | 2 | |
| 48 | 29 | 27 | 20 | 3 | 33 | 93.1 | 70.4 | 2 | |||
| Agar screen | |||||||||||
| Swab inoculation | Remel | 35 | 24 | 30 | 28 | 46 | 12 | 40.0 | 100 | —e | |
| 48 | 30 | 28 | 33 | 25 | 83.3 | 100 | —e | ||||
| Difco | 35 | 24 | 29f/27g | 27f/23g | 27f/35g | 29f/14g | 93.1f/51.8g | 92.6f/100g | 2f/1g | ||
| 48 | 30f/27g | 27f/23g | 25f/22g | 32f/26g | 100f/96.3g | 92.6f/100g | 1f/1g | ||||
| Spot inoculation | Remel | 30 | 24 | 30 | 28 | 44 | 14 | 46.7 | 100 | —e | |
| 48 | 30 | 28 | 39 | 19 | 63.3 | 100 | —e | ||||
| 35 | 24 | 30 | 28 | 38 | 20 | 66.7 | 100 | —e | |||
| 48 | 30 | 28 | 38 | 20 | 66.7 | 100 | —e | ||||
| Difco | 30 | 24 | 26 | 26 | 30 | 22 | 84.6 | 100 | 6 | ||
| 48 | 29 | 28 | 33 | 24 | 82.3 | 100 | 1 | ||||
| 35 | 24 | 29 | 27 | 36 | 20 | 70.0 | 100 | 2 | |||
| 48 | 30 | 28 | 32 | 26 | 83.3 | 96.4 | 0 | ||||
S, susceptible; I, intermediate; R, resistant.
Susceptibility breakpoint, ≤2 μg/ml.
Susceptibility breakpoint, ≤1 μg/ml.
One isolate was interpreted as susceptible but was mecA positive; this isolate was interpreted as resistant by the agar screen swab inoculation method with Difco medium prepared in-house (60 colonies at 0.6 μg/ml; 20 colonies at 6.0 μg/ml).
No control plate available.
Oxacillin concentration, 0.6 μg/ml.
Oxacillin concentration, 6.0 μg/ml.