Abstract
The genus Staphylococcus is the main causative agent of bone and joint infections (BJI) in which outcomes are impacted by both effective surgical and appropriate antimicrobial management. In this context, methicillin resistance (MR) detection is a microbiological challenge to optimize the anti-staphylococcal drug coverage and to secure the surgical procedure. During the last decade, molecular tools have been developed to rapidly detect bacterial-resistant strains in clinical samples. The GeneXpert MRSA/SA SSTI® assay (Cepheid, Sunnyvale, CA, USA) is a real-time PCR method aimed at detecting methicillin-resistant Staphylococcus aureus (MRSA) in skin and soft tissues infections. In the literature, this test has been reported to be diverted from its original purpose to be evaluated in surgical samples. Within the current review, we update the GeneXpert MRSA/SA SSTI® assay performance in staphylococcal species determination (i.e., S. aureus vs. coagulase-negative species) together with MR genotype detection, when performed in osteoarticular infections.
Highlights
Bone and joint infections (BJI) encompass a heterogenous group combining native joints and device-associated infections, covering children osteomyelitis, adults’ septic arthritis, spondylodiscitis, and prosthetic joint infections (PJI)
Beyond S. aureus (SA) and methicillinresistant SA (MRSA) identification, the assay allows for the specific detection of the genetic support of methicillin resistance (MR), the mecA gene, and interestingly provides the possibility to detect the presence of an MR staphylococcal (MRS) strain from the surgical site, whatever the species
We propose to review the performance of the GeneXpert MRSA/SA soft tissue infections (SSTI) R assay for SA, MRSA, and methicillin-resistant coagulase-negative staphylococci (MRCoNS) detection and discuss the reliability of such use in several bone and joint infections (BJI) contexts throughout recent articles
Summary
Bone and joint infections (BJI) encompass a heterogenous group combining native joints and device-associated infections, covering children osteomyelitis, adults’ septic arthritis, spondylodiscitis, and prosthetic joint infections (PJI). We propose to review the performance of the GeneXpert MRSA/SA SSTI R assay for SA, MRSA, and MRCoNS detection and discuss the reliability of such use in several BJI contexts throughout recent articles. The literature points out only seven publications dealing with the performances of the MRSA/SA SSTI R real-time PCR assay (Cepheid, Sunnyvale, CA) in BJI diagnosis according to distinct protocols.
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