The BD GeneOhm™ MRSA Assay is a qualitative in vitro diagnostic test for the direct detection of methicillin-resistant Staphylococcus aureus (MRSA) from a nasal specimen. Test procedure time for the assay is under two hours. Compared to culture methods requiring two to five days, this rapid turn-around time can be used to enhance any infection control program. The test provides a definitive result in a single assay.
The BD GeneOhm™ MRSA Assay enables hospitals to dramatically improve the identification of MRSA, which can effectively result in the prevention and control of MRSA infections.
Identifying the Situation
Rates of S. aureus infection have increased during the past two decades in North America and many European countries. Bacteremia due to S. aureus has been reported to be associated with higher mortality rates (15%-60%).1 Resistance to methicillin among S. aureus isolates is also a growing problem: up to 60% of nosocomial infections in patients in the intensive care unit (ICU) are due to methicillin-resistant S. aureus.2 In fact, MRSA has been identified by the Society for Healthcare and Epidemiology of America (SHEA) as one of the two “most out of control” antimicrobial-resistant pathogens in U.S. hospitals (VRE is the other).3 A 2004 study of a surgical ICU that implemented an active surveillance and contact precautions program found that the use of these methods decreased transmission of MRSA from 5% to 0.9%.4
Government and professional organizations are increasingly recommending more proactive procedures to identify, prevent, and control multi-drug resistant organisms (MDROs) such as MRSA.
CDC guidelines from 2002 recommend:5
SHEA 2003 guidelines go further by recommending:3
Prevention and Control of MRSA: The BD GeneOhm™ MRSA Assay
Extensive studies have demonstrated the advantages of a stringent infection control program including decreased hospital-acquired MRSA infections, length of stay, number of isolated patients, and significant savings from the decreased use of antibiotics.1,3 The availability of a definitive test result for MRSA within two hours of receiving the specimen enables decisions and actions one to three days earlier than standard culture-based methods.
The BD GeneOhm™ MRSA Assay detects a unique molecular sequence which confers a double specificity: half of this sequence comes from the S. aureus chromosome; the second half is within the genetic element carrying methicillin resistance, the SCCmec cassette.
With its speed and accuracy, the BD GeneOhm™ MRSA Assay provides a powerful new identification tool, which can effectively result in the prevention and control of MRSA colonization:
Remarkable annual cost savings have been demonstrated in hospitals implementing active MRSA surveillance programs. With surveillance, hospitals were able to better identify and control the reservoir of MRSA which resulted in significantly reduced rates of infection.
Jernigan et. al. assessed the cost and benefit at a university hospital where active surveillance cultures were performed for high-risk patients.7 The study estimated that an active surveillance culture program could save between $20,062 and $462,067 annually while preventing 8 to 41 MRSA infections.3 In another study, Chaix et. al. concluded that targeted screening (identification) and isolation (prevention) are the most cost-effective strategies over a range of MRSA carriage rates on admission, efficacy of the control program and infection rates following transmission.8
By offering the capability of delivering definitive MRSA results in less than two hours, the BD GeneOhm™ MRSA Assay from BD has the potential to dramatically improve the cost-effectiveness of an infection control program.
1. Cosgrove, SE et al., Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis. 2003 Jan 1;36(1):53-9.
2. National Nosocomial Infections Surveillance System (NNISS).
3. Muto, CA et al., SHEA Guideline for Preventing Nosocomial Transmission of Multidrug-Resistant Strains of Staphylococcus aureus and Enterococcus. ICHE 2003;24 (5):362-386.
4. Boyce, J.M., Harill N.L., Kohan C., Dumigan D.G., Ligi, C.E. Do infection control measures work for methicillin-resistant Staphylococcus aureus? Infect. Control Hosp. Epidemiol. 2004;25:395-401.
5. Center for Disease Control and Prevention (CDC) website: www.cdc.gov
6. Garner, JS et al., Guideline for isolation precautions in hospitals. The Hospital Infection Control Practices Advisory Committee. ICHE 1996;17 (1):53-80.
7. Jernigan et al., Effectiveness of contact isolation during a hospital outbreak of methicillin-resistant Staphylococcus aureus. Am J Epidemiol. 1996 Mar 1;143(5):496-504. Erratum in: Am J Epidemiol 1996 May 15;143(10):1079.
8. Chaix, C., et al. Control of endemic methicillin-resistant Staphylococcus aureus: a cost-benefit analysis in an intensive care unit. Jama 1999;282(18):1745-51.
9. Diekema, D. J., Dodgson, K. J., Sigurdardottir, B., Pfaller, M. A. Rapid Detection of Antimicrobial-Resistant Organism Carriage: an Unmet Clinical Need. J. Clin. Microbiol. 2004;42 (7): 2879-2883.