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The Combined Oxacillin Resistance and Coagulase (CORC) test for rapid identification and prediction of oxacillin resistance in Staphylococcus species directly from blood culture.
  1. Brian E Carey (bryanc1007{at}hotmail.com)
  1. Waterford Regional Hospital, Republic of Ireland
    1. Lara Nicol (llara.nicol{at}sgh.scot.nhs.uk)
    1. Southern General Hospital, United Kingdom

      Abstract

      We describe the Combined Oxacillin Resistance and Coagulase (CORC) protocol for rapid identification and determination of oxacillin-susceptibility in Staphylococcus spp from blood culture. It incorporates a modified direct Tube Coagulase Test (TCT) and a novel 4-hour multiplication-induction step, which increases the expression of staphylococcal PBP2a if present, facilitating detection by a commercial PBP2a latex agglutination kit. The protocol shows excellent sensitivity and specificity for determination of coagulase-positivity in staphylococci from patient blood cultures (96.8% (95%CI 81.5-99.8) and 100% (95%CI 75.9-100) respectively, N=47) and for prediction of oxacillin resistance in Staphylococcus aureus directly from patient blood cultures (100% (95%CI 59.8-100) and 100% (95%CI 82.2-100) respectively, N=31) within 5 hours of blood culture positivity.

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