Journal article
MRSA nasal swab PCR to de-escalate antibiotics in the emergency department
The American journal of emergency medicine, Vol.55, pp.133-137
05/01/2022
DOI: 10.1016/j.ajem.2022.03.009
PMID: 35313228
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) nasal swab polymerase chain reaction (PCR) assay has a 96.1–99.2% negative predictive value (NPV) in pneumonia and may be used for early de-escalation of MRSA-active antibiotic agents. Xu (2018), File (2010) [1,2].
The objective of our study was to determine if a negative MRSA PCR nasal swab collected in the emergency department (ED) improves early MRSA-active antibiotic de-escalation.
A single center observational cohort study used ICD-10 codes to identify records for adults admitted to the ED with a hospital discharge diagnosis of pneumonia. The primary outcome was proportion of patients with early de-escalation on an MRSA-active agent (≤ 1 dose). Secondary outcomes included rate of acute kidney injury (AKI), positive MRSA cultures (blood culture, respiratory sputum, tracheal aspirate), hospital length of stay (LOS), in-hospital mortality, and 30-day readmission rates.
A total of 341 patients were included in the study. Of the patients with an MRSA PCR swab, 35.2% of patients with a negative swab received >1 dose of MRSA-active agent compared to 52% of patients without an MRSA nasal swab (p < 0.01). There were no significant differences in secondary outcomes except readmission rate of 1.6% of patients that did not have an MRSA swab in the ED vs 6.6% of patients that received an MRSA swab in the ED.
MRSA PCR nasal swabs in the ED may serve as a useful tool for early MRSA-active antibiotic de-escalation when treating pneumonia.
Details
- Title: Subtitle
- MRSA nasal swab PCR to de-escalate antibiotics in the emergency department
- Creators
- Morganne A. Sindelar - University of Iowa Hospitals and ClinicsAnne E. Zepeski - University of IowaBrooke J. Lawler - University of IowaStephanie D. Johnston - University of IowaBrett A. Faine - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The American journal of emergency medicine, Vol.55, pp.133-137
- DOI
- 10.1016/j.ajem.2022.03.009
- PMID
- 35313228
- NLM abbreviation
- Am J Emerg Med
- ISSN
- 0735-6757
- eISSN
- 1532-8171
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 05/01/2022
- Academic Unit
- Emergency Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984544950602771
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