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. 2024 May 8;62(5):e0144523.
doi: 10.1128/jcm.01445-23. Epub 2024 Apr 1.

Automated detection of methicillin-resistant Staphylococcus aureus with the MRSA CHROM imaging application on BD Kiestra Total Lab Automation System

Erin McElvania  1 , Susan Mindel  2 , Jaap Lemstra  3 , Karin Brands  3 , Parul Patel  1 , Caryn E Good  4 , Didier Morel  5 , Cedrick Orny  6 , Jean-Marc Volle  6 , Marc Desjardins  7 , Daniel Rhoads  8
Affiliations

Automated detection of methicillin-resistant Staphylococcus aureus with the MRSA CHROM imaging application on BD Kiestra Total Lab Automation System

Erin McElvania et al. J Clin Microbiol. .

Abstract

The virulence of methicillin-resistant Staphylococcus aureus (MRSA) and its potentially fatal outcome necessitate rapid and accurate detection of patients colonized with MRSA in healthcare settings. Using the BD Kiestra Total Lab Automation (TLA) System in conjunction with the MRSA Application (MRSA App), an imaging application that uses artificial intelligence to interpret colorimetric information (mauve-colored colonies) indicative of MRSA pathogen presence on CHROMagar chromogenic media, anterior nares specimens from three sites were evaluated for the presence of mauve-colored colonies. Results obtained with the MRSA App were compared to manual reading of agar plate images by proficient laboratory technologists. Of 1,593 specimens evaluated, 1,545 (96.98%) were concordant between MRSA App and laboratory technologist reading for the detection of MRSA growth [sensitivity 98.15% (95% CI, 96.03, 99.32) and specificity 96.69% (95% CI, 95.55, 97.60)]. This multi-site study is the first evaluation of the MRSA App in conjunction with the BD Kiestra TLA System. Using the MRSA App, our results showed 98.15% sensitivity and 96.69% specificity for the detection of MRSA from anterior nares specimens. The MRSA App, used in conjunction with laboratory automation, provides an opportunity to improve laboratory efficiency by reducing laboratory technologists' labor associated with the review and interpretation of cultures.

Keywords: BD Kiestra; lab automation; methicillin-resistant Staphylococcus aureus (MRSA).

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Conflict of interest statement

S.M., J.L., D.M., C.O., J.-M.V., and K.B. are employees of the study sponsor, Becton, Dickinson and Company, and own BD shares; these authors have no other potential conflict of interest to disclose. D.R. has received research support for this investigation. He has also performed sponsored research in collaboration with Abbott, Altona, BD, bioMerieux, Cepheid, Luminex, Hardy Diagnostics, HelixBind, Hologic, Qiagen, Q-Linea, Roche, Specific Diagnostics, Cleveland Diagnostics, Thermo Fisher, & Vela Diagnostics; served as an advisor for Roche, Thermo Fisher, Luminex/DiaSorin, Seegene; received travel funds from Cepheid; and owns equity in Next Gen Diagnostics. M.D. has received research support for this investigation. P.P. and C.E.G. do not have conflicts of interest to disclose. E.M. has received research support for this investigation and is a sponsored speaker for BD.

Figures

Fig 1
Fig 1
Examples of agar plates by batch sorting categories (no growth, non-mauve growth, pure mauve, and mixtures of mauve and non-mauve growth).
Fig 2
Fig 2
Reconciliation of plates assessed by reference method (laboratory technologist). *Of the 1,268 MRSA (−) specimens, 1,023 had no growth and 245 had no mauve growth; of the 325 MRSA (+) specimens, 319 were true positive and 6 were false negative. Abbreviations: SOC, standard of care; MRSA, methicillin-resistant Staphylococcus aureus.
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