{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:10:17Z","timestamp":1782270617773,"version":"3.54.5"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010753","name":"National Health Laboratory Service","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010753","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Positive blood cultures showing Gram positive cocci in clusters signifies either\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      or the less-virulent coagulase-negative staphylococci. Rapid identification and methicillin susceptibility determination with the Xpert MRSA\/SA BC assay can improve management of\n                      <jats:italic>S. aureus<\/jats:italic>\n                      bloodstream infection and reduce inappropriate antibiotic use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively evaluated the Xpert MRSA\/SA BC assay in comparison with culture, on samples referred to our laboratory in the Western Cape, South Africa. We interviewed attending clinicians upon culture result availability, to assess antibiotic choices and estimate potential impact of the assay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 231 samples included, there was 100% concordance between the Xpert MRSA\/SA BC assay and culture (methicillin-resistant\n                      <jats:italic>S. aureus<\/jats:italic>\n                      15\/15, methicillin-susceptible\n                      <jats:italic>S. aureus<\/jats:italic>\n                      42\/42, coagulase-negative staphylococci 170\/170). Time to final result could be reduced by approximately 30\u2009h with the assay. Of the 178 patients with adequate antibiotic history, optimisation of antistaphylococcal therapy could have occurred more than 1 day sooner in 68.9% with\n                      <jats:italic>S. aureus<\/jats:italic>\n                      bloodstream infection (31\/45, 95% CI 53.2\u201381.4%). Six of the 11 patients with methicillin-resistant\n                      <jats:italic>S. aureus<\/jats:italic>\n                      bloodstream infection (54.5%) could have received anti-MRSA cover sooner. Fifty-four days of antibiotic therapy could have been spared, equating to 0.3\u2009days (95% CI, 0.2\u20130.4) saved per patient, driven by broad-spectrum beta-lactams (32\u2009days, in 18.0% of the cohort).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This assay has potential as an antimicrobial stewardship tool; costing and impact on clinical outcome in patients with\n                      <jats:italic>S. aureus<\/jats:italic>\n                      bloodstream infection should be assessed.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-021-05857-7","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T10:51:38Z","timestamp":1613559098000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Can the Xpert MRSA\/SA BC assay be used as an antimicrobial stewardship tool? A prospective assay validation and descriptive impact assessment study in a South African setting"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6701-9764","authenticated-orcid":false,"given":"Kessendri","family":"Reddy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Whitelaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,15]]},"reference":[{"key":"5857_CR1","doi-asserted-by":"publisher","first-page":"S246","DOI":"10.1086\/598187","volume":"48","author":"A Del Rio","year":"2009","unstructured":"Del Rio A, Cervera C, Moreno AN, Moreillon P, Mir\u00f3 JM. Patients at risk of complications of Staphylococcus aureus bloodstream infection. Clin Infect Dis. 2009;48:S246\u201353.","journal-title":"Clin Infect Dis"},{"issue":"4","key":"5857_CR2","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.diagmicrobio.2014.01.001","volume":"78","author":"O Yossepowitch","year":"2014","unstructured":"Yossepowitch O, Dan M, Kutchinsky A, Gottesman T, Schwartz-Harari O. A cost-saving algorithm for rapid diagnosis of Staphylococcus aureus and susceptibility to oxacillin directly from positive blood culture bottles by combined testing with BinaxNOW S. aureus and Xpert MRSA\/SA assay. Diagn Microbiol Infect Dis. 2014;78(4):352\u20135. Available from:. https:\/\/doi.org\/10.1016\/j.diagmicrobio.2014.01.001.","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"3","key":"5857_CR3","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1128\/JCM.03108-14","volume":"53","author":"BW Buchan","year":"2015","unstructured":"Buchan BW, Allen S, Burnham CD, Tekippe EM, Davis T, Levi M, et al. Comparison of the next-generation Xpert MRSA\/SA BC assay and the GeneOhm StaphSR assay to routine culture for identification of Staphylococcus aureus and methicillin-resistant S. aureus in positive-blood-culture broths. J Clin Microbiol. 2015;53(3):804\u20139.","journal-title":"J Clin Microbiol"},{"issue":"3","key":"5857_CR4","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/0196-6553(88)90053-3","volume":"16","author":"JS Garner","year":"1988","unstructured":"Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes J. CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988;16(3):128\u201340.","journal-title":"Am J Infect Control"},{"key":"5857_CR5","volume-title":"Supplement M100S. Performance standards for antimicrobial susceptibility testing. 26th ed","author":"CLSI","year":"2016","unstructured":"CLSI. Supplement M100S. Performance standards for antimicrobial susceptibility testing. 26th ed. Wayne: Clinical and Laboratory Standards Institute; 2016."},{"key":"5857_CR6","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.diagmicrobio.2015.10.014","volume":"84","author":"R Diaz","year":"2016","unstructured":"Diaz R, Ramalheira E, Afreixo V, Gago B. Methicillin-resistant Staphylococcus aureus carrying the new mecC gene \u2014 a meta-analysis. Diagn Microbiol Infect Dis. 2016;84:135\u201340.","journal-title":"Diagn Microbiol Infect Dis"},{"key":"5857_CR7","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/j.diagmicrobio.2011.02.006","volume":"70","author":"PG Kelley","year":"2011","unstructured":"Kelley PG, Grabsch EA, Farrell J, Xie S, Montgomery J, Mayall B, et al. Evaluation of the Xpert MRSA\/SA Blood Culture assay for the detection of Staphylococcus aureus including strains with reduced vancomycin susceptibility from blood culture specimens. Diagn Microbiol Infect Dis. 2011;70:404\u20137. Available from:. https:\/\/doi.org\/10.1016\/j.diagmicrobio.2011.02.006.","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"11","key":"5857_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1128\/JCM.01195-19","volume":"57","author":"FC Tenover","year":"2019","unstructured":"Tenover FC, Tickler IA, Le VM, Dewell S, Mendes RE, Goering RV. Updating molecular diagnostics for detecting methicillin- susceptible and methicillin-resistant Staphylococcus aureus isolates in blood culture bottles. J Clin Microbiol. 2019;57(11):1\u201311.","journal-title":"J Clin Microbiol"},{"issue":"7","key":"5857_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1128\/JCM.00530-18","volume":"56","author":"G Lee","year":"2018","unstructured":"Lee G, Pang S, Coombs W. Misidentification of Staphylococcus aureus by the Cepheid Xpert MRSA\/SA BC assay due to deletions in the spa gene. 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A waiver of individual informed consent was granted by Stellenbosch University\u2019s Human Health Research Ethics Committee (HREC), reference S14\/10\/201.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have neither financial nor non-financial competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"177"}}