Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-24T21:40:47.002Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical Utility of Dual Anterior Nares and Oropharynx MRSA Screening PCR for Patients with Suspected Pneumonia

Published online by Cambridge University Press:  22 November 2021

Michael A. Kessler Open the ORCID record for Michael A. Kessler [Opens in a new window] ,
Sandip Biswas ,
Tsokyi Choera ,
Derrick J. Chen  and
Alexander J. Lepak Open the ORCID record for Alexander J. Lepak [Opens in a new window]
Michael A. Kessler
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Sandip Biswas
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Tsokyi Choera
Affiliation:
Department of Medical Microbiology and Immunology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Derrick J. Chen
Affiliation:
Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Alexander J. Lepak*
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
*
Author for correspondence: Alexander J. Lepak, E-mail: ajlepak@medicine.wisc.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

We reviewed the electronic health records of 1,419 inpatients with anterior nares (AN) and oropharynx (OP) MRSA PCR tests. Concordance was 96.5%. In discordant cases, AN negative–OP positive results increased detection of probable MRSA pneumonia by only 0.3%. A dual testing approach has limited utility in detecting MRSA pneumonia and increases resource utilization.

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 9 , September 2022 , pp. 1242 - 1244
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This is an updated version of the original article. For details please see the notice at https://doi.org/10.1017/ice.2021.508.

PREVIOUS PRESENTATION. This study was presented in part at IDWeek 2019 on October 5, 2019, in Washington DC. Abstract #2153

References

Dangerfield, B, Chung, A, Webb, B, Seville, MT. Predictive value of methicillin-resistant Staphylococcus aureus (MRSA) nasal swab PCR assay for MRSA pneumonia. Antimicrob Agents Chemother 2014;58:859–864.CrossRefGoogle ScholarPubMed
Smith, MN, Brotherton, AL, Lusardi, K, Tan, CA, Hammond, DA. Systematic review of the clinical utility of methicillin-resistant Staphylococcus aureus (MRSA) nasal screening for MRSA pneumonia. Ann Pharmacother 2019;53:627–638.CrossRefGoogle ScholarPubMed
Parente, DM, Cunha, CB, Mylonakis, E, Timbrook, TT. The clinical utility of methicillin-resistant Staphylococcus aureus (MRSA) nasal screening to rule out MRSA pneumonia: a diagnostic meta-analysis with antimicrobial stewardship implications. Clin Infect Dis 2018;67:1–7.CrossRefGoogle ScholarPubMed
Mergenhagen, KA, Starr, KE, Wattengel, BA, Lesse, AJ, Sumon, Z, Sellick, JA. Determining the utility of methicillin-resistant Staphylococcus aureus nares screening in antimicrobial stewardship. Clin Infect Dis 2020;71:1142–1148.CrossRefGoogle ScholarPubMed
Boyce, JM, Pop, O-F, Abreu-Lanfranco, O, et al. A trial of discontinuation of empiric vancomycin therapy in patients with suspected methicillin-resistant Staphylococcus aureus healthcare-associated pneumonia. Antimicrob Agents Chemother 2013;57:1163.CrossRefGoogle Scholar
McKinnell, JA, Huang, SS, Eells, SJ, Cui, E, Miller, LG. Quantifying the impact of extranasal testing of body sites for methicillin-resistant Staphylococcus aureus colonization at the time of hospital or intensive care unit admission. Infect Control Hosp Epidemiol 2013;34:161–170.CrossRefGoogle ScholarPubMed
Mcbride, J, Schulz, L, Fox, B, Dipoto, J, Sippel, N, Osterby, K. Influence of a “No MRSA, No Pseudomonas ” comment to a respiratory culture in antibiotic utilization during the treatment of lower respiratory tract infection. Open Forum Infect Dis 2015;2:1500.CrossRefGoogle Scholar
Musgrove, MA, Kenney, RM, Kendall, RE, et al. Microbiology comment nudge improves pneumonia prescribing. Open Forum Infect Dis 2018;5:ofy162.CrossRefGoogle ScholarPubMed
Metlay, JP, Waterer, GW, Long, AC, et al. Diagnosis and Treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 2019;200(7):e45–e67.CrossRefGoogle ScholarPubMed
Hammond, DA, Smith, MN, Li, C, Hayes, SM, Lusardi, K, Bookstaver, PB. Systematic review and meta-analysis of acute kidney injury associated with concomitant vancomycin and piperacillin/tazobactam. Clin Infect Dis 2017;64:666–674.Google ScholarPubMed