Species-specific identification of methicillin resistance in staphylococci.

The ability to identify methicillin-resistant staphylococci by the disc diffusion method was evaluated using discs containing oxacillin (1, 5 and 10 micrograms), methicillin (10 micrograms) and cephalexin (30 micrograms). Strains of Staphylococcus aureus (67 strains) and coagulase-negative staphylococci (72 novobiocin-sensitive and 27 novobiocin-resistant strains) were studied using two inoculum densities (10(6) cfu/ml and 10(8) cfu/ml). Inhibitory zones were recorded after 18, 24 and 42 hours of incubation. A mecA-specific application of the polymerase chain reaction was used as a reference method. The inoculum of 10(8) cfu/ml and incubation for 24 hours were optimal for the identification of methicillin-resistant strains. However, one single disc was not sufficient for the identification of methicillin resistance in the different staphylococcal species. The mecA-positive strains of Staphylococcus aureus and novobiocin-resistant coagulase-negative species were clearly separated from the mecA-negative strains when the 5 micrograms oxacillin disc was used, whereas the 1 microgram oxacillin disc was optimal for the identification of the mecA-positive novobiocin-sensitive coagulase-negative strains.