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AdvanDx Announces FDA 510(k) Submission for mecA XpressFISH - Rapid Detection of MRSA From Positive Blood Cultures

AdvanDx today announced that it has submitted to the U.S. Food and Drug Administration for 510(k) clearance its new mecA XpressFISH™ test for the rapid detection of methicillin-resistant Staphylococcus aureus (MRSA) from S. aureus positive blood cultures. This assay will provide physicians with a new way to rapidly identify MRSA enabling them to implement appropriate treatment for patients with bloodstream infections.

Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to antibiotics commonly used to treat ordinary staphylococcal infections. An estimated 80,461 invasive MRSA infections occurred in the U.S. in 2011. Of these, 48,353 were healthcare associated community onset infections; 14,156 were hospital-onset infections; and 16,560 were community-associated infections.(1)

Methicillin-resistance is almost exclusively caused by the presence and expression of the mecA gene that encodes a unique penicillin-binding protein (PBP2a) that has low affinity for methicillin and other b-lactam drugs. mecA XpressFISH is a qualitative fluorescence in situ hybridization (FISH) assay that utilizes peptide nucleic acid (PNA) probes hybridizing to mecA messenger RNA (mRNA) sequences on smears from blood cultures containing Staphylococcus aureus (SA).  This "phenotypic" mRNA-targeting approach makes XpressFISH unique in its mechanism of MRSA identification.

"This is a significant breakthrough in how we identify MRSA," says James M. Coull, Ph.D, Chief Technology Officer for AdvanDx. "By targeting mecA mRNA, mecA XpressFISH rapidly detects the presence of the mecA gene, and determines whether the gene is transcriptionally functional and therefore able to confer resistance to broad classes of antibiotics, such as penicillins and cephalosporins. This information should help clinicians quickly determine the best course of antibiotic treatment."

Although identification of MRSA is used to guide effective therapy, conventional laboratory methods can take 48 hours to  determine whether S. aureus bacteria are resistant. mecA XpressFISH will enable laboratories to rapidly detect MRSA directly from S. aureus positive blood cultures in about an hour.  The rapid determination of MRSA by mecA XpressFISH should enable clinicians to prescribe more effective appropriate therapy sooner for MRSA-infected patients.

A Proven Track Record with Staphylococcal Bloodstream Infections

mecA XpressFISH is the latest addition to AdvanDx's easy-to-use, molecular-based diagnostics platform that provides rapid identification of bloodstream pathogens in minutes instead of days. AdvanDx also markets the QuickFISH platform for rapid identification of Gram-positive and Gram-negative bacteria as well as PNA FISH for Candida species.

Since 2003, the use of AdvanDx's flagship product, PNA FISH for rapid identification of staphylococcal bloodstream pathogens has dramatically improved therapy decisions and outcomes for patients with bloodstream infections by helping physicians and pharmacists optimize antibiotic therapy earlier. A clinical study performed at the Washington Hospital Center (Washington, D.C.) demonstrated that rapid identification and notification of PNA FISH results reduced ICU and overall mortality rates by 82% and 53% respectively, while reducing antibiotic use for patients with CNS positive blood cultures. In a separate study performed at the University of Maryland Medical Center (Baltimore, MD) rapid PNA FISH results, helped reduce unnecessary vancomycin use by 4.5 doses, length of stay by 2 days and hospital costs by $4,005 for patients with CNS contaminated blood cultures. (2,3)

1. JAMA National Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections, United States, 2011
2. Ly et al. Ther Clin Risk Manag. 2008 Jun;4(3):637-40.
3. J Antimicrob Chemother. 2006 Jul;58(1):154-8.

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