Abstract :
The infection caused by Staphylococcus aureus that is resistant to beta lactam antibiotic known as methicillin-resistant S. aureus (MRSA). This bacteria less the choice of effective antibiotic, increase hospital stay and cost, and mortality. Because of these problems, MRSA diagnostic testing must be done accurately. The gold standard of MRSA diagnostic testing PCR. Other that PCR, some methods that can be used for MRSA detection are antibiotic disc and chromogenic media. The three of them have diverse sensitivity, specificity, and turnaround time. Evaluating the diagnostic testing accuracy can be done by using sensitivity, specificity, and turnaround time. Based on the description above, this study has been carried out to evaluate the MRSA diagnostic test using antibiotic discs, chromogenic media, and PCR with a systematic review method. This research used Preferred Reporting Items for Systematic Review and Meta-Analyses of Diagnostic Test Accuracy (PRISMA-DTA) for extracting and synthesizing data. 2,239 articles yielded and 59 of them fit the eligibility criteria used in this systematic review. Quadas-2 tool was used for risk of bias analysis. The sensitivity and specificity of MRSA diagnostic methods using antibiotic disc, chromogenic media and PCR were: 47,3-100% and 66,2-100%; 70-100% and 30-100%, 57,69-100% and 78,6-100% respectively. The incubation time is 16-48 hours for antibiotic disc, 18-48 hours for chromogenic media. The turnaround time is 36-48 hours for disc antibiotic and 58 minutes-6,5 hours for PCR. High resource laboratories can use PCR as a diagnostic method for MRSA, while limited resources laboratories can use antibiotic disc and chromogenic media. We conclude that MRSA diagnostic method using PCR has higher specificity and faster turnaround time than antibiotic disc, while chromogenic media has higher sensitivity than those two methods.
