Ho Y.-C.SHAN-CHWEN CHANGLin S.-R.Wang W.-K.2020-12-302020-12-3020090095-1137https://www.scopus.com/inward/record.uri?eid=2-s2.0-66149087199&doi=10.1128%2fJCM.01197-08&partnerID=40&md5=134ad68c47df6beffb7b279436cb6010https://scholars.lib.ntu.edu.tw/handle/123456789/535997Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is known to be a poor prognostic factor. While several PCR assays for the detection of MRSA in various clinical samples were recently reported, the possibility that a quantitative PCR assay could be used to quantify and monitor MRSA bacteremia has not been explored. In this study, we established a quantitative real-time PCR assay for the mecA gene using known copy numbers of a plasmid containing mecA DNA as a standard and the previously described mecA-specific primers and probe (P. Francois et al., J. Clin. Microbiol. 41:254-260, 2003). We employed this assay to examine 250 sequential whole-blood samples from 20 adult patients, including 13 survivors and 7 nonsurvivors, with culture-proven MRSA bacteremia at the intensive care units of National Taiwan University Hospital between 1 July 2006 and 31 January 2007. The levels of mecA DNA in the nonsurvivors were significantly higher than those in the survivors during the three periods of bacteremia examined (days 0 to 2, 3 to 5, and 6 to 8) (P = 0.003 by two-tailed Mann-Whitney U test). Moreover, the nonsurvivors had higher mecA DNA levels than the survivors after 3 days and 7 days of anti-MRSA therapy (medians for nonsurvivors and survivors at 3 days, 5.86 and 4.30 log copies/ml, respectively; medians for nonsurvivors and survivors at 7 days, 5.21 and 4.36 log copies/ml, respectively; P = 0.02 and P = 0.04, respectively, by two-tailed Mann-Whitney U test). Together, these findings suggest that the level of mecA DNA in blood could potentially be used to monitor MRSA bacteremia and evaluate responses to therapy. Copyright ? 2009, American Society for Microbiology. All Rights Reserved.[SDGs]SDG3bacterial DNA; clindamycin; cotrimoxazole; erythromycin; fusidic acid; gentamicin; minocycline; oxacillin; penicillin binding protein 2a; primer DNA; teicoplanin; vancomycin; adult; aged; antibiotic sensitivity; article; bacteremia; blood analysis; clinical article; controlled study; female; human; male; methicillin resistant Staphylococcus aureus; mortality; nonhuman; plasmid; priority journal; prognosis; rank sum test; real time polymerase chain reaction; Adult; Aged; Aged, 80 and over; Bacteremia; Bacterial Proteins; DNA, Bacterial; Female; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Polymerase Chain Reaction; Staphylococcal Infections; Taiwan; Time Factors; Treatment Outcome; methicillin resistant Staphylococcus aureusjournal article10.1128/JCM.01197-0819279177