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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EExamination of nasal swabs from patients in hospital units at high risk of methicillin-resistant \u003Cem\u003EStaphylococcus aureus\u003C\/em\u003E (MRSA) revealed the superiority of the XPert MRSA Gen 3 system compared with the BD-MAX MRSA system in terms of detection accuracy and speed.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Epolymerase chain reaction\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EMRSA\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Emethicillin-resistant \u003Cem\u003EStaphylococcus aureus\u003C\/em\u003E\n            \u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Egrowth-based assay\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EXPert MRSA Gen 3\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EBD-MAX MRSA\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Elaboratory techniques\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ebacterial infections\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EA head-to-head comparison of 2 automated, polymerase chain reaction\u2013based systems for the detection of methicillin-resistant \u003Cem\u003EStaphylococcus aureus\u003C\/em\u003E (MRSA) in nasal swabs and culture samples from 119 high-risk patients has demonstrated the superiority in terms of detection accuracy and speed of the Xpert MRSA Gen 3 system over the BD-MAX MRSA system.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EMartin Rottman, MD, PhD, H\u00f4pital Raymond Poincar\u00e9 AP-HP, Garches, France, and colleagues presented findings that the ongoing evaluation of the diagnostic performance of MRSA molecular assays is necessary, given the emergence of new strains with \u003Cem\u003Emec\u003C\/em\u003E gene variations or altered staphylococcal cassette chromosomal junctions. This study focused on the performance of Xpert and BD-MAX automated molecular assays in comparison to 2 culture-based methods on nasal swab samples acquired from patients in the intensive care unit, orthopedic surgery unit, and rehabilitation medicine unit of H\u00f4pital Raymond Poincar\u00e9. A hospital policy had designated these units as being at high risk for MRSA outbreaks in the tertiary-care center.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EConsecutive nasal swab samples were collected from both anterior nares of 119 patients over a 45-day period. These and 36 nasal swab samples collected from patients who were culture-positive for MRSA were used for the 2 automated molecular assays as well as 2 culture-based methods. The culture-based methods were the Tryptic Soy Broth enriched culture method (gold standard) followed by MRSA select agar (culture time, 24 to 72 hours), and direct culture on MRSA select agar (culture time, 18 hours). A bank of 12 control strains was also tested, including a bovine strain that contained \u003Cem\u003EmecC\u003C\/em\u003E. Each sample was dispensed in 500 \u00b5L distilled deionized water, with aliquots of 100 \u00b5L used for each of these four methods. A total of 119 consecutive samples were tested, followed by testing of 36 direct positive samples. In the subsequent statistical analyses, the agreement of each method was compared with the Tryptic Soy Broth enriched culture (gold standard).\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EBased on the results of the gold standard method, 12 of 119 patients (10%) harbored MRSA in their nasal passages. Both automated assays detected the \u003Cem\u003EmecC\u003C\/em\u003E strain. The Xpert system correctly identified MRSA in 45 of 47 samples (95.7%) known to be MRSA-positive, with 98.7% agreement with the gold standard method. The BD-MAX assay correctly identified 42 of 48 samples (87.5%), with a 94.0% agreement with the gold standard method. The difference in accuracies significantly favored the Xpert system (\u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.023, McNemar nonparametric test). When MRSA culture-negative samples were tested, the Xpert assay correctly identified all 107 samples tested. The BD-MAX assay correctly identified 100 of 103 samples. The 3 false-positive results in the BD-MAX assay were traced to problems with the interpretive software of the instrument. Positive predictive values were 100% and 93.3% with Xpert and BD-MAX, respectively, whereas negative predictive values were 99.0% and 96.1%, respectively.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe hands-on time needed to run 4 samples in the Xpert system was 12 minutes, with a turn-around time of 91 minutes. The comparable times for the BD-MAX system were 15 and 117 minutes.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe data demonstrate the detection superiority and lower hands-on time of the Xpert automated assay compared to the BD-MAX automated assay in detecting MRSA in nasal samples obtained from patients in units regarded to be at high risk for MRSA.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/48\/12.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzllxf\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}