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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
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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
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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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