Prediction of methicillin-resistant Staphylococcus aureus bloodstream infection: do we need rapid diagnostic tests?

Delerue, Thibaud; Cordel, Hugues; Figoni, Julie; Dziri, Samira; Billard-Pomarès, Typhaine; Bouchaud, Olivier; Carbonnelle, Étienne; Zahar, Jean‐Ralph

doi:10.1007/s10096-019-03556-5

Cited by 5 publications

(2 citation statements)

References 34 publications

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“…Inappropriate antibiotic therapy in cases of S. aureus BSI has been found to be associated with a higher risk of mortality and extended hospital length of stays, therefore appropriate antimicrobial therapy seems to be the most important factor associated with a better clinical outcome. Even though MRSA epidemiology varies between countries, MRSA risk factors can be easily identifiable, such as previous MRSA infection or colonization, coming from long-term care facility, and chronic renal diseases [ 76 ]. The risk factors should be also considered before expensive rapid diagnostic tests are performed.…”

Section: Discussionmentioning

confidence: 99%

Rapid Detection of Methicillin-Resistant Staphylococcus aureus Directly from Blood for the Diagnosis of Bloodstream Infections: A Mini-Review

et al. 2020

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Staphylococcus aureus represents a major human pathogen able to cause a number of infections, especially bloodstream infections (BSI). Clinical use of methicillin has led to the emergence of methicillin-resistant S. aureus (MRSA) and MRSA-BSI have been reported to be associated with high morbidity and mortality. Clinical diagnosis of BSI is based on the results from blood culture that, although considered the gold standard method, is time-consuming. For this reason, rapid diagnostic tests to identify the presence of methicillin-susceptible S. aureus (MSSA) and MRSA isolates directly in blood cultures are being used with increasing frequency to rapidly commence targeted antimicrobial therapy, also in the light of antimicrobial stewardship efforts. Here, we review and report the most common rapid non-molecular and molecular methods currently available to detect the presence of MRSA directly from blood.

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Section: Discussionmentioning

confidence: 99%

Rapid Detection of Methicillin-Resistant Staphylococcus aureus Directly from Blood for the Diagnosis of Bloodstream Infections: A Mini-Review

et al. 2020

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“…Given the aforementioned challenges, a system that facilitates timely and reliable identification of newly admitted patients who are likely to be colonized with an MDRO would be quite useful to improve patient safety and effective utilization of critical hospital resources ( 53 ). By accurately identifying significant risk factors, this system can help define high-risk subpopulations and hence, could enable the implementation of a cost-effective targeted screening program.…”

Section: Introductionmentioning

confidence: 99%

A Data-Driven Framework for Identifying Intensive Care Unit Admissions Colonized With Multidrug-Resistant Organisms

Çaǧlayan

Barnes

Pineles

et al. 2022

Front. Public Health

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BackgroundThe rising prevalence of multi-drug resistant organisms (MDROs), such as Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), and Carbapenem-resistant Enterobacteriaceae (CRE), is an increasing concern in healthcare settings.Materials and MethodsLeveraging data from electronic healthcare records and a unique MDRO universal screening program, we developed a data-driven modeling framework to predict MRSA, VRE, and CRE colonization upon intensive care unit (ICU) admission, and identified the associated socio-demographic and clinical factors using logistic regression (LR), random forest (RF), and XGBoost algorithms. We performed threshold optimization for converting predicted probabilities into binary predictions and identified the cut-off maximizing the sum of sensitivity and specificity.ResultsFour thousand six hundred seventy ICU admissions (3,958 patients) were examined. MDRO colonization rate was 17.59% (13.03% VRE, 1.45% CRE, and 7.47% MRSA). Our study achieved the following sensitivity and specificity values with the best performing models, respectively: 80% and 66% for VRE with LR, 73% and 77% for CRE with XGBoost, 76% and 59% for MRSA with RF, and 82% and 83% for MDRO (i.e., VRE or CRE or MRSA) with RF. Further, we identified several predictors of MDRO colonization, including long-term care facility stay, current diagnosis of skin/subcutaneous tissue or infectious/parasitic disease, and recent isolation precaution procedures before ICU admission.ConclusionOur data-driven modeling framework can be used as a clinical decision support tool for timely predictions, characterization and identification of high-risk patients, and selective and timely use of infection control measures in ICUs.

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Clinical impact of implementation of rapid diagnostic testing of blood cultures with Staphylococcus aureus on patient outcomes

Gritte

Morneau

Frei

et al. 2021

Diagnostic Microbiology and Infectious Disease

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Prediction of methicillin-resistant Staphylococcus aureus bloodstream infection: do we need rapid diagnostic tests?

Cited by 5 publications

References 34 publications

Rapid Detection of Methicillin-Resistant Staphylococcus aureus Directly from Blood for the Diagnosis of Bloodstream Infections: A Mini-Review

Rapid Detection of Methicillin-Resistant Staphylococcus aureus Directly from Blood for the Diagnosis of Bloodstream Infections: A Mini-Review

A Data-Driven Framework for Identifying Intensive Care Unit Admissions Colonized With Multidrug-Resistant Organisms

Clinical impact of implementation of rapid diagnostic testing of blood cultures with Staphylococcus aureus on patient outcomes

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