Rapid identification of methicillin-resistant Staphylococcus aureus (MRSA) and patient management

ABSTRACTThere is an urgent public health need for early and reliable detection of methicillin-resistant Staphylococcus aureus (MRSA) infection and carriage to direct antibiotic therapy, to inform patient isolation and decontamination procedures, and to more effectively control cross-infection. Limited advances have been made in culture-based tests, while considerable promise is offered by a new generation of molecular assays based on real-time PCR. Several commercially available PCR tests can rapidly detect MRSA from nasal swabs with high sensitivity and specificity (both 90–100%), although technical issues remain to be resolved and comparative data are lacking. Crucially, evidence must be provided for the clinical efficacy, effectiveness and cost–benefit of implementing these technologies. Furthermore, adaptations in healthcare systems and professional behaviour will be required if full advantage is to be taken of any truly rapid, point-of-care tests that become available.