Nasal screening is useful in excluding methicillin-resistant Staphylococcus aureus in ventilator-associated pneumonia

Nasal-Swab Results for Methicillin-Resistant Staphylococcus aureus and Associated Infections

“…Unfortunately, there were too few individual endotracheal tube aspirate, sputum, and BAL samples to analyze. However, studies including respiratory samples 15,17,18 have reported sensitivity and specificity similar to those found in the current study.…”

“…Reported values for sensitivity and specificity of MRSA nasal-swab screening alone for predicting MRSA infection have ranged from 50.0% to 88.0% and from 83.0% to 100.0%, respectively. [15][16][17][18][19][20] The comparability of these results is limited by the different nasal- swab assays used at each site. Many studies used polymerase chain reaction, which has been shown to increase sensitivity 22 relative to the chromogenic medium used at the current study site.…”

“…The required sample size was calculated using precision calculations based on different sensitivity and specificity estimates found in the current literature, [15][16][17][18][19][20] and the largest sample size was chosen to ensure adequate precision for the study. The precision calculation was based on a 95% confidence interval (CI), an infinite population size, and a precision of 5%.…”

“…[15][16][17][18][19][20] The populations studied have included patients with various types of pneumonia, skin and soft-tissue infections, or multiple sites of potential infection, as well as patients admitted to the intensive care unit. [15][16][17][18][19][20] Furthermore, the current literature [15][16][17][18][19][20] focuses on patients with documented MRSA infection or patients at high risk for nosocomial infection, with patients being followed to determine whether they developed MRSA infection. To our knowledge, no studies have examined consecutive patients presenting to hospital who were started on empiric IV vancomycin therapy.…”

Using MRSA Screening Tests To Predict Methicillin Resistance in Staphylococcus aureus Bacteremia

“…However, the use of MRSA screening tests to guide antibiotic therapy remains poorly studied. Prior studies have evaluated their use in multiple situations, including intra-abdominal (10), postoperative (11), respiratory (12,13), and overall documented clinical infections (14). There is little published on the use of MRSA screening in bloodstream infection.…”