{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:29:56Z","timestamp":1787016596399,"version":"build-2736575974"},"reference-count":31,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T00:00:00Z","timestamp":1335830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Although the presence of\n                    <jats:italic>mecA<\/jats:italic>\n                    is the genotypic determinant of methicillin-resistant\n                    <jats:named-content content-type=\"genus-species\">Staphylococcus aureus<\/jats:named-content>\n                    (MRSA), certain MRSA strains, especially community-associated MRSA (C-MRSA), can display an oxacillin MIC in the Clinical and Laboratory Standards Institute susceptible breakpoint range (\u22642 \u03bcg\/ml). Among 91 and 180 isolates thought to be methicillin-susceptible\n                    <jats:named-content content-type=\"genus-species\">S. aureus<\/jats:named-content>\n                    (MSSA) with oxacillin MICs of 2 and 1 \u03bcg\/ml as determined by the Sensititre broth microdilution test initially, 52 (57.1%) and 6 (3.3%), respectively, were\n                    <jats:italic>mecA<\/jats:italic>\n                    positive. These\n                    <jats:italic>mecA<\/jats:italic>\n                    -positive low-oxacillin-MIC isolates belong to the dominant Taiwan C-MRSA clone (clonal complex [CC] 59), 56 of which carried SCC\n                    <jats:italic>mec<\/jats:italic>\n                    type V and were\n                    <jats:italic>pvl<\/jats:italic>\n                    positive, and 43 of which belonged to\n                    <jats:italic>spa<\/jats:italic>\n                    CC t437. All 271 isolates were retested by Sensititre, as well as by Vitek II and disk diffusion (DD). Based on the oxacillin results, the sensitivities of the Sensititre, Vitek II, and DD methods were 48.3% (28\/58), 46.6% (27\/58), and 89.6% (52\/58), respectively. Although cefoxitin was better at detecting these isolates, 12.1, 10.4, and 5.2% of these isolates were still misidentified as MSSA by Sensititre, Vitek II, and DD, respectively. These results highlight the difficulty in the accurate identification of MRSA with borderline oxacillin MICs in the CC59:SCC\n                    <jats:italic>mec<\/jats:italic>\n                    V clone, which likely has contributed to its spread in the health care and community settings. Since this clone has now been detected in other countries, and since other C-MRSA lineages have also been found to have low-level \u03b2-lactam resistance, the findings of the present study may be relevant to other regions. Further studies are warranted to determine the extent and clinical impact of such misidentification.\n                  <\/jats:p>","DOI":"10.1128\/jcm.06711-11","type":"journal-article","created":{"date-parts":[[2012,3,1]],"date-time":"2012-03-01T00:57:08Z","timestamp":1330563428000},"page":"1679-1683","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":56,"title":["<i>mecA<\/i>\n                    -Positive Staphylococcus aureus with Low-Level Oxacillin MIC in Taiwan"],"prefix":"10.1128","volume":"50","author":[{"given":"Feng-Jui","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Wen","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Her","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Yin","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jui-Fen","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yih-Ru","family":"Shiau","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsai-Ling Yang","family":"Lauderdale","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"TSAR Hospitals","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.9.4719-4730.2005"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.10.4.781"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2200"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2009.05.020"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1111.050367"},{"key":"e_1_3_2_7_2","unstructured":"Clinical and Laboratory Standards Institute. 2008. 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