Clinical utility of negative methicillin-resistant Staphylococcus aureus (MRSA) nasal surveillance swabs in skin and skin structure infections.

Autor: Burgoon R; Department of Pharmacy, Medical University of South Carolina Health, Charleston, SC. Electronic address: burgoonr@musc.edu., Weeda E; Department of Pharmacy, Medical University of South Carolina College of Pharmacy, Charleston, SC., Mediwala KN; Department of Pharmacy, Medical University of South Carolina Health, Charleston, SC., Raux BR; Department of Pharmacy, Medical University of South Carolina Health, Charleston, SC.
Jazyk: angličtina
Zdroj: American journal of infection control [Am J Infect Control] 2022 Aug; Vol. 50 (8), pp. 941-946. Date of Electronic Publication: 2021 Dec 25.
DOI: 10.1016/j.ajic.2021.12.005
Abstrakt: Background: Negative methicillin-resistant Staphylococcus aureus (MRSA) nasal swabs have a high negative predictive value of approximately 99% in respiratory infections. There is, however, a lack of data evaluating its use beyond respiratory infections.
Methods: We conducted a retrospective analysis to determine the clinical utility of MRSA swabs for identifying MRSA-associated skin and skin structure infections (SSSIs) and the potential effects on antimicrobial stewardship efforts. Baseline characteristics, culture data, and antibiotic data were collected to determine the difference in duration of vancomycin therapy. Positive predictive value, negative predictive value, sensitivity, and specificity were secondary outcomes.
Results: A total of 473 patients were included, of which 156 patients had a positive MRSA nasal swab and 317 patients had a negative swab. The median duration of vancomycin was 4 days in the positive group and 3 days in the negative group (P = .01). The positive predictive value and negative predictive value were 22.4% and 97.5%. The sensitivity and specificity were 81.4% and 71.9%.
Conclusion: Patients with a negative MRSA nasal swab received approximately 1 day less of vancomycin, which represented a decrease in drug administered. The negative predictive value for SSSIs is promising, showing potential for the role of MRSA nasal swabs in de-escalating therapy.
(Copyright © 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: