title: Screening for methicillin-resistant Staphylococcus aureus colonization using sponges.
abstract: OBJECTIVE Nasal swab culture is the standard method for identifying methicillin-resistant Staphylococcus aureus (MRSA) carriers. However, this method is known to miss a substantial portion of those carrying MRSA elsewhere. We hypothesized that the additional use of a sponge to collect skin culture samples would significantly improve the sensitivity of MRSA detection. DESIGN Hospitalized patients with recent MRSA infection were enrolled and underwent MRSA screening of the forehead, nostrils, pharynx, axilla, and groin with separate swabs and the forehead, axilla, and groin with separate sponges. Staphylococcal cassette chromosome mec (SCCmec) typing was conducted by polymerase chain reaction (PCR). PATIENTS A total of 105 MRSA patients were included in the study. RESULTS At least 1 specimen from 56.2% of the patients grew MRSA. Among patients with at least 1 positive specimen, the detection sensitivities were 79.7% for the swabs and 64.4% for the sponges. Notably, 86.4% were detected by a combination of sponges and nasal swab, and 72.9% were detected by a combination of pharyngeal and nasal swabs, whereas only 50.9% were detected by nasal swab alone (P<0.0001 and P=0.0003, respectively). Most isolates had SCCmec type II (59.9%) and IV (35.7%). No correlation was observed between the SCCmec types and collection sites. CONCLUSION Screening using a sponge significantly improves MRSA detection when used in addition to screening with the standard nasal swab.
authors: 1Division of Infectious Diseases,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors: Chang-Seop
authors: CS
authors: Lee
authors: 1Division of Infectious Diseases,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors: Bianca
authors: B
authors: Montalmont
authors: 1Division of Infectious Diseases,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors: Jessica A
authors: JA
authors: O'Hara
authors: 1Division of Infectious Diseases,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors: Alveena
authors: A
authors: Syed
authors: 1Division of Infectious Diseases,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors: Charma
authors: C
authors: Chaussard
authors: 1Division of Infectious Diseases,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors: Traci L
authors: TL
authors: McGaha
authors: 1Division of Infectious Diseases,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors: Diana L
authors: DL
authors: Pakstis
authors: 3Department of Prevent Medicine,Chonbuk National University Medical School,Jeonju,Republic of Korea.
authors: Ju-Hyung
authors: JH
authors: Lee
authors: 1Division of Infectious Diseases,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors: Kathleen A
authors: KA
authors: Shutt
authors: 1Division of Infectious Diseases,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors: Yohei
authors: Y
authors: Doi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000382:microbiology; D002353:Carrier State / Q000175:diagnosis*; D005260:Female; D005546:Forehead / Q000382:microbiology; D006119:Groin / Q000382:microbiology; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D008875:Middle Aged; D058889:Molecular Typing; D009666:Nose / Q000382:microbiology; D010614:Pharynx / Q000382:microbiology; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D012867:Skin / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000175:diagnosis*; D015503:Surgical Sponges / Q000382:microbiology*; D055815:Young Adult
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