Difference on Cefoxitin and Oxacillin Disk Test on In Vitro MRSA Detection (Meticillin Resistant Staphylococcus aureus) Experimental Study on Microbiology Laboratorium of Medicine Faculty of UNISSULLA

Hana Tiyas Mustikawati*  -  Medical Faculty of Sultan Agung Islamic University, Jl. Kaligawe KM 4 Semarang 50012 Ph. (024) 6583584 fax. (024) 6594366, Indonesia
Ridha Wahyutomo  -  Microbiology Departement of Medical Faculty of Sultan Agung Islamic University, Indonesia
Qathrunnada Djaman  -  Pharmacology Departement of Medical Faculty of Sultan Agung Islamic University, Indonesia

(*) Corresponding Author

Background: MRSA phenotypic detection has been a problem since it was found in 1962. Some studies explain that the diffusion method of cefoxitin
and oxacilin disk test can be used to detect MRSA. Objective: knowing if there is difference between cefoxitin disk test and oxacilin disk test to detect
MRSA.
Method: laboratory experimental research with diagnostic test design. Research was done at the laboratory of medicine faculty of UNISSULA using 24 watch glasses, 12 with MRSA bacteria (Meticillin Resisten Staphylococcus aureus), and the other 12 with MSSA bacteria (Meticillin sensitive Staphylococcus aureus). specimentsThe results were classified into sensitive and resistant category based on CLSI standard (Clinical Laboratory Standards Institute).
Hypothesis test using fisher test, with significance level <0,05
Results: speciments MRSA detection using cefoxitin disk resulted 12 resistant speciments and no sensitive speciments. The oxacilin disk resulted 9 resistant speciments and 3 sensitive speciments. MSSA detection using cefoxitin disk resulted no resistant speciments and 12 sensitive speciments, oxacilin disk resulted no resistant speciments and 12 sensitive speciments. Diagnostic test was done by CEBM statistic calculator. The sensitivity and specificity value of MRSA sampels using cefoxitin disk were 96,2% & 96,2%, PPV (positive predictive value) 96,2%, NPV (negative predictive value) with was 96,2%. While the oxacilin disk, the sensitivity was 73,1%, specificity 96,2%, PPV 95,0%, NPV 73,8%. The result of fisher test for cefoxitin disk and oxacilin disk was p=0.000 meant there was difference between cefoxitin disk test and oxacilin disk test to detect MRSA.
Conclusion: diffusion method in cefoxitin disk is better than oxacillin disk in MRSA detection.

Keywords: MRSA, MSSA, Diffusion, PPV, NPV

  1. Broekema, N.M., Van, T.T., Monson, T.A., Marshall, S.A., Warshauer, D.M., 2009, Comparison of cefoxitin and oxacillin disk diffusion methods for detection of mecA-mediated resistance Staphylococcus aureus in a large-scale study. J Clin Microbiol. Jan;47(1):217-9.
  2. Brown, D.F.J., Edwards, D.I., Hawkey, P.M., Morrison, D., Ridgway, G.L., Towner, K.J., Wren, M.W.D, 2005, Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA). J Antimicrob Chemother, 56:1000– 1018.
  3. Clarence, J., Fernandes, 1., Lorna, A., Fernandes, 1., Peter Collignon2., 2005, Cefoxitin resistance as a surrogate marker for the detection of methicillinresistant Staphylococcus aureus. CLSI. 2006. Performance standards for antimicrobial disk susceptibility tests. Approved standard M2-A9, ninth ed. CLSI, Wayne, PA.
  4. CLSI. 2007. Performance standards for antimicrobial susceptibility testing. CLSI Approved standard M100-S17, clinical and laboratory standards institute, Wayne, PA
  5. Cohen, M. L., Edward S. W., and Falkow, S., 2008, Common R-Plasmids in Staphylococcus aureus and Staphylococcus epidermidis During a Nosocomial Staphylococcus aureus Outbreak.
  6. Farmakologi dan terapi, 2007,departemen farmakologi dan terapeuik fakultas kedokteran universitas Indonesia, Edisi Kelima. Jakarta; balai penerbit FKUI. 664-683
  7. Felten, A., B. Grandry, P. H. Lagrange, and I. Casin, 2002, Evaluation of three techniques for detection of low-level methicillin-resistant Staphylococcus aureus (MRSA): a disk diffusion method with cefoxitin and moxalactam, the Vitek 2 system, and the MRSA-screen latex agglutination test. J. Clin. Microbiol. 40:2766- 2771.
  8. Juuti, K, 2004, Surface protein Pls of methicillin-resistant Staphylococcus aureus role in adhesion, invasion and pathogenesis, and evolutionary aspects. [Disertation]. Helinski: Department of Biological and EnvironmentalSciences Faculty of Biosciences. p. 61-63
  9. Kenneth H. Rand and Herbert J. Houck., 2004. Synergy of Daptomycin with Oxacillin and Other ß-Lactams against Methicillin-Resistant Staphylococcus aureus. Antimicrob Agents Chemother. 48: 2871-2875
  10. Madhusudhan, N.S., Deepa, S., Shoba, D.N., 2011, correlation of cefoxitin disc diffusion test and oxacillin disc diffusion test fordetecting mec a mediated oxacillin resistant staphylococcus aureus. Journal of Pharmaceutical and Biomedical Science.
  11. Mimica, M. J., E. N. Berezin, R. L. B. Carvalho, L., A. P. Safadi, E. Schneider, and H. H. Caiaffa- Filho, 2007. Detection of methicillin resistance in Staphylococcus aureus isolated from pediatric patients: is the cefoxitin disk diffusion test accurate enough? Braz. J. Infect. Dis. 11:415-417.
  12. Mulholland, Adegbola. Bacterial infections - A major cause of death among children in Africa. NEJM 2005; 352:75-7.
  13. Navy Environmental Health Center, 2005, Guidelines for the Management of Community Acquired Methicillin- Resistant Staphylococcus aureus (CA-MRSA) Infections in the US Navy and Marine Corps. http://www-nehc.med.navy.mil/Downloads/prevmed/CPG_MRSA_20050516_final.pdf.
  14. Pottumarthy, S., T. R. Fritsche, and R. N. Jones, 2005, Evaluation of alternative disk diffusion methods for detecting mecA-mediated oxacillin resistance in an international collection of staphylococci: validation
  15. report from the SENTRY antimicrobial surveillanceprogram. Diagn. Microbiol. Infect. Dis. 51:57-62.
  16. Swenson, J. M., D. Lonsway, S. McAllister, A. Thompson, L. Jevitt, W. Zhu, and J. B. Patel, 2007, Detection of mecA-mediated resistance using referenceand commercial testing methods in a collection ofStaphylococcus aureus expressing borderline oxacillin MICs. Diagn. Microbiol. Infect. Dis. 5833-39.
  17. Van Leeuwen WB, 2003, Molecular approaches for the epidemiological characterization of S. Aureus strain, p 55-95. In Fluit Ad C, and Franz-Josef Schitz (editors), MRSA: Current perspectives. Caister Academic Press, Norfolk England.
  18. Velasco, D., del Mar Tomas, M., Cartelle, M., Beceiro, A., Perez, A., Molina, F., Moure, R., Villanueva, R. & Bou, G. (2004). Evaluation of different methods for detecting methicillin (oxacillin) resistance in Staphylococcus aureus. J Antimicrob Chemother 55, 379–382.

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is published by Fakultas Kedokteran Universitas Islam Sultan Agung Semarang, Indonesia.
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ISSN: 2339-093X (Online) | 2085-1545 (Print)
DOI : 10.30659/sainsmed

This work is licensed under a Creative Commons Attribution 4.0 International License

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