Methicillin-resistant Staphylococcus aureus (MRSA): identification and susceptibility testing techniques.

Many traditional techniques are useful for identification of MRSA strains, including techniques for detection of penicillin-resistance, such as the nitrocefin disk. Techniques for assessing methicillin-resistance vary from growth on special media or at a lower temperature, to detection of the mecA gene by manual (latex agglutination) and automated (PCR) methods. Technique development is now geared toward making MRSA identification more rapid. Real-time PCR has sped MRSA detection, but can be costly. Resistance to other drugs is also an issue. Clindamycin resistance may need to be induced, so a special disk diffusion test can be performed. Vancomycin resistance is becoming an issue, so alternative drugs need to be identified. Drugs that are currently available for MRSA infections include: daptomycin, linezolid, quinupristin/dalfopristin, and tigecycline. Drugs that are in the development phase include: ceftobiprole, dalbavancin, oritavancin, and telavancin. These drugs provide a promising arsenal against MRSA.