CRISPR-Cas-associated SCCmec Variants in Methicillin-resistant Staphylococcus aureus Evade Rapid Diagnostic Detection.
case_series · Level IV
Where this comes from
- Record sourced from PubMed, PMID 41254867.
- Also identified by DOI 10.1093/infdis/jiaf575 and PMC identifier 13017219.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Rapid molecular assays guiding treatment of methicillin-resistant Staphylococcus aureus detect SCCmec (Xpert) or the SCCmec-orfX junction (BCID2). Sequence variation in this region can disrupt primer binding, yielding false-negative results. Investigation of a missed bloodstream infection linked escape to a CRISPR-Cas-associated SCCmec variant, leading to identification of 64 variants from 45 patients-2% of 2432 screened. Misdiagnosis was restricted to clonal complex 5, a hospital-associated lineage; 11 of 40 SCCmec/junctions evaded detection by BCID2 or Xpert. Variants had mecA instability and circulated in healthcare settings. Our findings reveal a unique escape mechanism and underscore a threat to diagnostic accuracy.
Medical subject headings
- Methicillin-Resistant Staphylococcus aureus
- Staphylococcal Infections
- CRISPR-Cas Systems
- Genetic Variation