Nasal methicillin-resistant Staphylococcus aureus polymerase chain reaction: a potential use in guiding antibiotic therapy for pneumonia

The role at admission of nasal polymerase chain reaction (PCR) for patients with methicillin-resistant Staphylococcus aureus (MRSA) in guiding antibiotic therapy for lower respiratory tract infection is unknown. To determine whether nasal MRSA PCR at admission can predict the absence of MRSA in lowe...

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Bibliographic Details
Published in:Permanente journal 2015-01, Vol.19 (1), p.34-36
Main Authors: Johnson, Jennifer A, Wright, Michael E, Sheperd, Lyndsay A, Musher, Daniel M, Dang, Bich N
Format: Article
Language:English
Subjects:
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Carrier State - diagnosis
Carrier State - drug therapy
Carrier State - microbiology
Female
Hospitals, Urban - statistics & numerical data
Humans
Male
Methicillin-Resistant Staphylococcus aureus - isolation & purification
Middle Aged
Nasal Cavity - microbiology
Original Research & Contributions
Pneumonia, Staphylococcal - diagnosis
Pneumonia, Staphylococcal - drug therapy
Pneumonia, Staphylococcal - microbiology
Polymerase Chain Reaction - statistics & numerical data
Predictive Value of Tests
Prospective Studies
Retrospective Studies
Sensitivity and Specificity
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Summary:The role at admission of nasal polymerase chain reaction (PCR) for patients with methicillin-resistant Staphylococcus aureus (MRSA) in guiding antibiotic therapy for lower respiratory tract infection is unknown. To determine whether nasal MRSA PCR at admission can predict the absence of MRSA in lower respiratory tract secretions. We performed a retrospective study of adult patients admitted to a large urban hospital. Patients had a nasal MRSA PCR test and a lower respiratory tract culture obtained within 48 hours of admission and the culture yielded S aureus. Sensitivity, specificity, and positive and negative predictive values. Our results showed high sensitivity (93.3%) and negative predictive value (95.2%) of nasal PCR for MRSA in the lower respiratory tract. With its high sensitivity and negative predictive value, a nasal MRSA PCR test performed within 48 hours of hospital admission could help guide the discontinuation of MRSA-directed empiric antibiotic therapy in patients who are unlikely to be infected with this organism. A prospective study is needed to confirm these findings.
ISSN:1552-5767
1552-5775
DOI:10.7812/TPP/14-101