title: Triple swabbing allows sensitive MRSA detection in dermatologic patients of a university tertiary care hospital.
abstract: BACKGROUND
  To optimize preventive measures to control MRSA, we investigated retrospectively the suitability of a multiple site screening model and the optimal sampling technique to detect MRSA in a university-based phlebology and skin cancer center in Germany.
  
  
  METHODS
  During 4.5 years samples of 3 712 inpatients in a dermatologic department were analyzed for MRSA by conventional microbiologic cultures and in parallel by PCR. Samples were taken from nares, wounds and skin lesions.
  
  
  RESULTS
  MRSA was detected in 60 inpatients (1.6%). 268 of 7 269 (3.7%) samples at admission and during hospital stay were found positive ñ 96 (35.8%) of these were swabs of nares, 59 (22.0%) surveillance swabs, 53 (19.8%) wound swabs and 42 (15.7%) from other dermatologic lesions. Twenty-five of 60 patients (41.7%) were found positive only in the nares, 10 (16.7%) patients only in wounds and 4 (6.7%) patients only in lesions. 166 (61.9%) of all positive culture samples became positive 24 hours after cultivation, 86 (32.1%) after 48 hours, and 16 (6.0%) after 72 hours.
  
  
  CONCLUSIONS
  Highest sensitivity to detect MRSA can be reached by combining three swabs: nares, wounds and skin lesions (ìtriple-testî). Culture of screening specimens for 72 hours is recommended.
authors.affiliation: Department of Dermatology of the Ernst Moritz Arndt University, Greifswald, Germany. georg.daeschlein@uni-greifswald.de
authors.forename: Georg
authors.initials: G
authors.lastname: Daeschlein
authors.forename: Tina
authors.initials: T
authors.lastname: Bloom
authors.forename: Sebastian
authors.initials: S
authors.lastname: von Podewils
authors.forename: Ojan
authors.initials: O
authors.lastname: Assadian
authors.forename: Johann H T
authors.initials: JH
authors.lastname: Wagenvoort
authors.forename: Helene
authors.initials: H
authors.lastname: Riebe
authors.forename: Sebastian
authors.initials: S
authors.lastname: Fochler
authors.forename: Abdulkareem
authors.initials: A
authors.lastname: Al-Jebori
authors.forename: Syrus
authors.initials: S
authors.lastname: Karsai
authors.forename: Ellen
authors.initials: E
authors.lastname: Kaisermayer
authors.forename: Hermann
authors.initials: H
authors.lastname: Haase
authors.forename: Sebastian
authors.initials: S
authors.lastname: Scholz
authors.forename: Michael
authors.initials: M
authors.lastname: Jünger
mesh_terms: D000046:Academic Medical Centers; D003428:Cross Infection / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D009666:Nose / Q000382:microbiology*; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*