The effect of rapid screening for methicillin-resistant Staphylococcus aureus (MRSA) on the identification and earlier isolation of MRSA-positive patients.

Hdl Handle:
http://hdl.handle.net/10147/124146
Title:
The effect of rapid screening for methicillin-resistant Staphylococcus aureus (MRSA) on the identification and earlier isolation of MRSA-positive patients.
Authors:
Creamer, Eilish; Dolan, Anthony; Sherlock, Orla; Thomas, Toney; Walsh, John; Moore, Joan; Smyth, Edmond; O'Neill, Eoghan; Shore, Anna; Sullivan, Derek; Rossney, Angela S; Cunney, Robert; Coleman, David; Humphreys, Hilary
Affiliation:
Department of Clinical Microbiology, Education and Research Centre, Royal College of Surgeons, Ireland. eilishcreamer@rcsi.ie
Citation:
The effect of rapid screening for methicillin-resistant Staphylococcus aureus (MRSA) on the identification and earlier isolation of MRSA-positive patients. 2010, 31 (4):374-81 Infect Control Hosp Epidemiol
Journal:
Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
Issue Date:
Apr-2010
URI:
http://hdl.handle.net/10147/124146
DOI:
10.1086/651093
PubMed ID:
20184438
Abstract:
(1) To determine whether rapid screening with polymerase chain reaction (PCR) assays leads to the earlier isolation of patients at risk for methicillin-resistant Staphylococcus aureus (MRSA) colonization, (2) to assess compliance with routine MRSA screening protocols, (3) to confirm the diagnostic accuracy of the Xpert MRSA real-time PCR assay (Cepheid) by comparison with culture, and (4) to compare turnaround times for PCR assay results with those for culture results.; Before-and-after study conducted in a 700-bed acute tertiary care referral hospital. Study periods were (1) a 5-week period before PCR testing began, (2) a 10-week period when the PCR assay was used, and (3) a 5-week period after PCR testing was discontinued.; Among 489 at-risk patients, MRSA was isolated from 20 (33%) of 60 patients during period 1, 77 (22%) of 349 patients during period 2, and 18 (23%) of 80 patients during period 3. Twenty-two (27%) of 82 at-risk patients were not screened during period 1, compared with 40 (10%) of 389 at-risk patients not screened during period 2 (P < .001). More MRSA-positive patients were preemptively isolated during periods 1 and 3 compared with period 2 (34 [24%] of 140 vs 28 [8%] of 389; P < .001); however, more MRSA-positive patients were isolated after notification of MRSA-positive results during period 2 (47 [13%] of 349) compared with periods 1 and 3 (2 [1%] of 140; P < .001). The sensitivity, specificity, positive predictive value, and negative predictive value of the PCR assay were 95%, 97%, 82%, and 99%, respectively. The mean turnaround time from receipt of specimens in the laboratory to PCR assay result was 2.6 hours.; Rapid screening with the Xpert MRSA PCR assay facilitated compliance with screening policies and the earlier isolation of MRSA-positive patients. Discrepant results confirm that PCR testing should be used as a screening tool rather than as a diagnostic tool.
Item Type:
Article
Language:
en
MeSH:
Agar; Bacterial Typing Techniques; Bacteriological Techniques; Chromogenic Compounds; Culture Media; Guideline Adherence; Humans; Mass Screening; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Polymerase Chain Reaction; Predictive Value of Tests; Risk Factors; Sensitivity and Specificity; Staphylococcal Infections; Time Factors
ISSN:
1559-6834

Full metadata record

DC FieldValue Language
dc.contributor.authorCreamer, Eilishen
dc.contributor.authorDolan, Anthonyen
dc.contributor.authorSherlock, Orlaen
dc.contributor.authorThomas, Toneyen
dc.contributor.authorWalsh, Johnen
dc.contributor.authorMoore, Joanen
dc.contributor.authorSmyth, Edmonden
dc.contributor.authorO'Neill, Eoghanen
dc.contributor.authorShore, Annaen
dc.contributor.authorSullivan, Dereken
dc.contributor.authorRossney, Angela Sen
dc.contributor.authorCunney, Roberten
dc.contributor.authorColeman, Daviden
dc.contributor.authorHumphreys, Hilaryen
dc.date.accessioned2011-03-10T13:04:05Z-
dc.date.available2011-03-10T13:04:05Z-
dc.date.issued2010-04-
dc.identifier.citationThe effect of rapid screening for methicillin-resistant Staphylococcus aureus (MRSA) on the identification and earlier isolation of MRSA-positive patients. 2010, 31 (4):374-81 Infect Control Hosp Epidemiolen
dc.identifier.issn1559-6834-
dc.identifier.pmid20184438-
dc.identifier.doi10.1086/651093-
dc.identifier.urihttp://hdl.handle.net/10147/124146-
dc.description.abstract(1) To determine whether rapid screening with polymerase chain reaction (PCR) assays leads to the earlier isolation of patients at risk for methicillin-resistant Staphylococcus aureus (MRSA) colonization, (2) to assess compliance with routine MRSA screening protocols, (3) to confirm the diagnostic accuracy of the Xpert MRSA real-time PCR assay (Cepheid) by comparison with culture, and (4) to compare turnaround times for PCR assay results with those for culture results.-
dc.description.abstractBefore-and-after study conducted in a 700-bed acute tertiary care referral hospital. Study periods were (1) a 5-week period before PCR testing began, (2) a 10-week period when the PCR assay was used, and (3) a 5-week period after PCR testing was discontinued.-
dc.description.abstractAmong 489 at-risk patients, MRSA was isolated from 20 (33%) of 60 patients during period 1, 77 (22%) of 349 patients during period 2, and 18 (23%) of 80 patients during period 3. Twenty-two (27%) of 82 at-risk patients were not screened during period 1, compared with 40 (10%) of 389 at-risk patients not screened during period 2 (P < .001). More MRSA-positive patients were preemptively isolated during periods 1 and 3 compared with period 2 (34 [24%] of 140 vs 28 [8%] of 389; P < .001); however, more MRSA-positive patients were isolated after notification of MRSA-positive results during period 2 (47 [13%] of 349) compared with periods 1 and 3 (2 [1%] of 140; P < .001). The sensitivity, specificity, positive predictive value, and negative predictive value of the PCR assay were 95%, 97%, 82%, and 99%, respectively. The mean turnaround time from receipt of specimens in the laboratory to PCR assay result was 2.6 hours.-
dc.description.abstractRapid screening with the Xpert MRSA PCR assay facilitated compliance with screening policies and the earlier isolation of MRSA-positive patients. Discrepant results confirm that PCR testing should be used as a screening tool rather than as a diagnostic tool.-
dc.language.isoenen
dc.subject.meshAgar-
dc.subject.meshBacterial Typing Techniques-
dc.subject.meshBacteriological Techniques-
dc.subject.meshChromogenic Compounds-
dc.subject.meshCulture Media-
dc.subject.meshGuideline Adherence-
dc.subject.meshHumans-
dc.subject.meshMass Screening-
dc.subject.meshMethicillin-Resistant Staphylococcus aureus-
dc.subject.meshMicrobial Sensitivity Tests-
dc.subject.meshPolymerase Chain Reaction-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshRisk Factors-
dc.subject.meshSensitivity and Specificity-
dc.subject.meshStaphylococcal Infections-
dc.subject.meshTime Factors-
dc.titleThe effect of rapid screening for methicillin-resistant Staphylococcus aureus (MRSA) on the identification and earlier isolation of MRSA-positive patients.en
dc.typeArticleen
dc.contributor.departmentDepartment of Clinical Microbiology, Education and Research Centre, Royal College of Surgeons, Ireland. eilishcreamer@rcsi.ieen
dc.identifier.journalInfection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of Americaen
dc.description.provinceLeinster-
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