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Screening for Methicillin-Resistant Staphylococcus aureus Colonization Using Sponges

Published online by Cambridge University Press:  05 January 2015

Chang-Seop Lee ,
Bianca Montalmont ,
Jessica A. O’Hara ,
Alveena Syed ,
Charma Chaussard ,
Traci L. McGaha ,
Diana L. Pakstis ,
Ju-Hyung Lee ,
Kathleen A. Shutt  and
Yohei Doi
Chang-Seop Lee
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania Department of Internal Medicine and Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea
Bianca Montalmont
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Jessica A. O’Hara
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Alveena Syed
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Charma Chaussard
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Traci L. McGaha
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Diana L. Pakstis
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Ju-Hyung Lee
Affiliation:
Department of Prevent Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea
Kathleen A. Shutt
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Yohei Doi*
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
*
Address correspondence to Yohei Doi, MD, PhD, Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, S829 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261 ([email protected]).
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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.

Infect Control Hosp Epidemiol 2014;36(1): 28–33

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 1 , January 2015 , pp. 28 - 33
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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