title: Clinical utility of a nasal swab methicillin-resistant Staphylococcus aureus polymerase chain reaction test in intensive and intermediate care unit patients with pneumonia.
abstract: This retrospective study aimed to validate the concordance between nasal swab methicillin-resistant Staphylococcus aureus (MRSA) polymerase chain reaction (PCR) test and respiratory culture and to determine the number of potentially preventable days of anti-MRSA therapy in patients with pneumonia. Two hundred adult inpatients in the intensive and intermediate care units were included. The nasal swab MRSA PCR test was positive in 55 (27.5%) patients. MRSA was isolated from respiratory culture in 21 (10.5%) patients. The nasal swab MRSA PCR test demonstrated 90.5% sensitivity, 79.9% specificity, 34.5% positive predictive value, and 98.6% negative predictive value. Anti-MRSA therapy was initiated in 168 (84%) patients. Patients in the study received a combined 782days of anti-MRSA therapy; 300days were considered potentially preventable. This study suggests that the nasal swab MRSA PCR test may be used to guide discontinuation of anti-MRSA antibiotics in patients with clinically confirmed pneumonia in the intensive or intermediate care units.
authors: St. Mary's Medical Center, Huntington, WV, USA. Electronic address: steph.giancola@gmail.com.
authors: Stephanie E
authors: SE
authors: Giancola
authors: St. Mary's Medical Center, Huntington, WV, USA.
authors: Ai Thi
authors: AT
authors: Nguyen
authors: Marshall University School of Pharmacy, Huntington, WV, USA.
authors: Binh
authors: B
authors: Le
authors: Marshall University School of Pharmacy, Huntington, WV, USA.
authors: Omar
authors: O
authors: Ahmed
authors: Marshall University School of Pharmacy, Huntington, WV, USA.
authors: Catherine
authors: C
authors: Higgins
authors: St. Mary's Medical Center, Huntington, WV, USA; Marshall University School of Pharmacy, Huntington, WV, USA.
authors: James A
authors: JA
authors: Sizemore
authors: St. Mary's Medical Center, Huntington, WV, USA.
authors: Kara W
authors: KW
authors: Orwig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D009297:Nasal Mucosa / Q000382:microbiology*; D011023:Pneumonia, Staphylococcal / Q000175:diagnosis* / Q000188:drug therapy; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cap; HCAP; MRSA; PCR; Pneumonia