For the direct identification of Methicillin resistant Staphylococcus aureus (MRSA) and Extended-Spectrum Beta-lactamase (ESBL) producing Enterobacteriaceae from clinical samples, what are the most appropriate media and the cheapest one?
a-Using selective Soft Salt-Mannitol Agar–Cloxacillin Test (SSMAC) after Mir et al.,(1998) various obtained isolates inoculated onto SSMAC tubes then being incubated at 35°C for 24 hrs and the results as follows;Positive result for MRSA colonization: The appearance of a bright-yellow color intermediate result: An orange to pale-yellow color
Negative result: a pale-red color.
b- Confirmed by disc diffusion sensitivity testing after Ciftci et al.,(2009) .
It was performed using 5 μg oxacillin discs. On Mueller Hinton Agar, according to NCCLS recommendation, oxacillin complete inhibition zone diameter of ≤12 mm were considered resistant, those with inhibition zone of ≥13 mm were susceptible.
Manitol Salt Agar Containing 1 % w/v Cloxacillin or oxacillin and media for MRSA only called MRSA agar
For ESBL detection with improved specificity you may visit the link attached...
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3993656/pdf/zjm1483.pdf
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