Current Trends in Rapid Diagnostics for Methicillin-Resistant Staphylococcus aureus and Glycopeptide-Resistant Enterococcus Species

Hospital-acquired (HA) infections are an increasing global problem. Methicillin-resistant Staphylococcus aureus (MRSA) and glycopeptide-resistant Enterococcus (GRE) are multidrugresistant organisms and are particularly frequent causes of HA infections that often prove difficult and expensive to treat. Major sources of MRSA and GRE causing infections are either the patient’s own floras (endogenous infection), those acquired from another person (cross-infection), or those from substances recently contaminated by a human source (environmental infection). Active surveillance cultures from patients for carriage of MRSA and GRE facilitate an early contact isolation (and even treatment), thus preventing spread in the hospital and reducing costs (42). However, the time to result with conventional cultures is 2 to 3 days, which allows these organisms a sizeable time window for potential spread prior to the institution of contact precautions. Recently, several “rapid” diagnostic tests have been introduced that would be very beneficial in decreasing the time to detection, therefore reducing the risk of nosocomial transmission and infections, especially in high-risk patients. This review discusses the current state of the art on rapid and direct detection methods for MRSA and GRE from patient material and hopes to facilitate the infectious disease specialist or microbiologist in choosing an appropriate diagnostic test.