title: Nasal methicillin-resistant Staphylococcus aureus polymerase chain reaction: a potential use in guiding antibiotic therapy for pneumonia.
abstract: BACKGROUND
  The role at admission of nasal polymerase chain reaction (PCR) for patients with methicillin-resistant Staphylococcus aureus (MRSA) in guiding antibiotic therapy for lower respiratory tract infection is unknown.
  
  
  OBJECTIVE
  To determine whether nasal MRSA PCR at admission can predict the absence of MRSA in lower respiratory tract secretions.
  
  
  METHODS
  We performed a retrospective study of adult patients admitted to a large urban hospital. Patients had a nasal MRSA PCR test and a lower respiratory tract culture obtained within 48 hours of admission and the culture yielded S aureus.
  
  
  METHODS
  Sensitivity, specificity, and positive and negative predictive values.
  
  
  RESULTS
  Our results showed high sensitivity (93.3%) and negative predictive value (95.2%) of nasal PCR for MRSA in the lower respiratory tract.
  
  
  CONCLUSIONS
  With its high sensitivity and negative predictive value, a nasal MRSA PCR test performed within 48 hours of hospital admission could help guide the discontinuation of MRSA-directed empiric antibiotic therapy in patients who are unlikely to be infected with this organism. A prospective study is needed to confirm these findings.
authors.affiliation: Pulmonary and Critical Care Physician at Centennial Medical Center in Nashville, TN. jennifer03johnson@yahoo.com.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Johnson
authors.affiliation: Clinical Pharmacist at Williamson County Medical Center in Franklin, TN. michaelwright54@hotmail.com.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Wright
authors.affiliation: Clinical Pharmacist at Texas Health Presbyterian Hospital in Dallas, TX. LyndsaySheperd@texashealth.org.
authors.forename: Lyndsay A
authors.initials: LA
authors.lastname: Sheperd
authors.affiliation: Professor of Medicine in the Section of Infectious Diseases at Baylor College of Medicine in Houston, TX. daniel.musher@va.gov.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Musher
authors.affiliation: Assistant Professor of Medicine in the Section of Infectious Diseases at Baylor College of Medicine in Houston, TX. bndang@bcm.edu.
authors.forename: Bich N
authors.initials: BN
authors.lastname: Dang
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002353:Carrier State / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology*; D011023:Pneumonia, Staphylococcal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000900:Anti-Bacterial Agents