title: Simplified screening in an emergency department detected methicillin-resistant Staphylococcus aureus.
abstract: BACKGROUND
  All patients admitted to Danish hospitals are screened for methicillin-resistant Staphylococcus aureus (MRSA) by a questionnaire consisting of 19 questions issued by the Danish Health and Medicines Authority (DHMA). This study aimed to evaluate which of the questions were most useful. Furthermore, we assessed if other questions were more adequate and if a simplified screening model would perform equal to or better than the one presently used.
  
  
  METHODS
  Swabs were obtained for MRSA culture from patients who were more than ten years old and who had been admitted to an emergency department (ED). All DHMA questions together with a range of additional questions were answered.
  
  
  RESULTS
  Among the 1,220 patients who participated, 0.9% were MRSA carriers. Only three DHMA questions were associated with a significant risk of MRSA carriage. The additional questions associated with MRSA were "stayed with a non-Danish family within the past three years" and "daily contact with children at a nursery or kindergarten". A new model with only five questions increased the sensitivity insignificantly from 18-55% to 73% in the revised model, whereas no changes were seen for specificity, predictive values or likelihood ratios.
  
  
  CONCLUSIONS
  The DHMA's targeted screening for MRSA detection contained only few questions with significant association to MRSA carrier stage. A model based on only five questions seems to insignificantly improve the MRSA screening in this population. In order to develop a more simple and effective screening model, we recommend that our findings be tested in another ED patient population.
  
  
  BACKGROUND
  Southern Jutland Hospital funded this study.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: christian.backer.mogensen@rsyd.dk.
authors.forename: Christian Backer
authors.initials: CB
authors.lastname: Mogensen
authors.forename: Poul
authors.initials: P
authors.lastname: Kjældgaard
authors.forename: Charlotte
authors.initials: C
authors.lastname: Jensen
authors.forename: Ming
authors.initials: M
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000175:diagnosis* / Q000382:microbiology; D002648:Child; D003718:Denmark; D004636:Emergency Service, Hospital; D006801:Humans; D008403:Mass Screening / Q000379:methods; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000382:microbiology; D011795:Surveys and Questionnaires; D055815:Young Adult