{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:30:12Z","timestamp":1784194212995,"version":"3.55.0"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2016,6,21]],"date-time":"2016-06-21T00:00:00Z","timestamp":1466467200000},"content-version":"unspecified","delay-in-days":9303,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[1991,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Three distinctly different mechanisms of methicillin resistance have been described in Staphylococcus aureus. The best-documented and probably most important mechanism is production of a unique, low affinity penicillin-binding protein, PBP 2\n                    <jats:sub>a<\/jats:sub>\n                    Strains possessing PBP 2\n                    <jats:sub>a<\/jats:sub>\n                    are resistant to methicillin, oxacillin, and probably all other currently available b-lactam antibiotics. Two additional mechanisms of reduced susceptibility to methicillin have been described. Borderline resistance (BORSA) to the semi-synthetic penicillins has been attributed to the hyperproduction of normal staphylococcal b-lactamase. A third mechanism has recently been advanced that describes an intermediate level of resistance to methicillin due to production of modified, normal PBPs with reduced affinity for b-lactams (MODSA). Little is known regarding the prevalence or clinical significance of the BORSA and MODSA strains. The most reliable in vitro susceptibility test methods for detecting MRSA (strains possessing PBP 2,) include the microdilution minimum inhibitory concentration (MIC) test (with 2% NaCl supplemented broth), the oxacillin agar screen plate test (incorporating 6 ug\/ml oxacillin in 4% NaCl supplemented agar), and the National Committee for Clinical Laboratory Standards (NCCLS) disk diffusion test with oxacillin. All three methods use direct inoculum preparation and incubation of tests at 35\u00b0C for a full 24 hours.\n                  <\/jats:p>","DOI":"10.1086\/646233","type":"journal-article","created":{"date-parts":[[2009,9,15]],"date-time":"2009-09-15T16:46:42Z","timestamp":1253033202000},"page":"14-19","source":"Crossref","is-referenced-by-count":39,"title":["Mechanisms of Methicillin Resistance in\n                    <i>Staphylcoccus aureus<\/i>\n                    and Methods for Laboratory Detection"],"prefix":"10.1017","volume":"12","author":[{"given":"James H.","family":"Jorgensen","sequence":"first","affiliation":[{"name":"University of Texas Health Science Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,6,21]]},"reference":[{"key":"S0195941700015861_ref025","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1128\/JCM.26.9.1675-1678.1988","article-title":"Salt-supplemented medium for testing 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of the source of Mueller-Hinton agar and resistance frequency on the detection of methicillin-resistant Staphylococcus aureus","volume":"21","author":"Hindler","year":"1985","journal-title":"J Clin Microbiol"},{"key":"S0195941700015861_ref014","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1128\/JCM.23.5.832-839.1986","article-title":"The role of b-lactamase in staphylococcal resistance to penicillinase-resistant penicillins and cephalosporins","volume":"23","author":"McDougal","year":"1986","journal-title":"J Clin Microb"},{"key":"S0195941700015861_ref021","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1128\/JCM.18.5.1226-1236.1983","article-title":"Interlaboratory variation of antibiograms of methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains with conventional and commercial testing systems","volume":"18","author":"Aldridge","year":"1983","journal-title":"J Clin 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