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Methicillin-resistant Staphylococcus aureus (MRSA) screening upon inpatient hospital admission: Is there concordance between nasal swab results and samples taken from skin and soft tissue?

Published online by Cambridge University Press:  12 August 2020

Natasha J. Petry ,
Anna D. Montgomery Open the ORCID record for Anna D. Montgomery [Opens in a new window] ,
Kimberly D. P. Hammer  and
Tze Shien Lo
Natasha J. Petry
Affiliation:
Department of Pharmacy Practice, North Dakota State University School of Pharmacy, Fargo, North Dakota
Anna D. Montgomery*
Affiliation:
Fargo Veterans’ Affairs Health Care System, Fargo, North Dakota Department of Public Health, North Dakota State University, Fargo, North Dakota
Kimberly D. P. Hammer
Affiliation:
Fargo Veterans’ Affairs Health Care System, Fargo, North Dakota Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
Tze Shien Lo
Affiliation:
Fargo Veterans’ Affairs Health Care System, Fargo, North Dakota Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
*
Author for correspondence: Anna D. Montgomery, E-mail: [email protected]
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Abstract

Background:

Methicillin-resistant Staphylococcus aureus (MRSA) infections are associated with increased mortality and healthcare costs. In 2007, a Veterans’ Affairs (VA) hospital implemented a MRSA nasal screening program, following a nationwide VA mandate, in an effort to reduce healthcare-associated MRSA infections.

Objective:

To evaluate the correlation between the nasal screening results for MRSA and culture results of wound and tissue sites.

Methods:

This retrospective study was conducted on inpatients at our VA hospital. Patients were included if they had undergone nasal screening for MRSA plus culture of a wound or tissue site within 30 days of hospital admission.

Results:

In total, 337 patients underwent nasal screening and wound culture and 211 underwent nasal screening and wound and tissue cultures. The prevalence of MRSA nasal colonization was 14.2% for wound samples and 15.2% for tissue samples. The sensitivities of MRSA nasal screening for detecting MRSA were 64.6% for wound cultures and 65.5% for tissue cultures. Specificities were 86.2% and 88.8% for wound and tissue cultures, respectively. The positive predictive values (PPVs) were 43.7% and 51.2% for wound and tissue cultures, respectively, and the negative predictive values (NPVs) were high at 93.6% and 93.5%, respectively.

Conclusions:

In cases of wound or tissue samples for which culture results are pending, a negative MRSA nasal swab may be a component of the decision to withhold or discontinue MRSA-active agents.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 11 , November 2020 , pp. 1298 - 1301
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Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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