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Rapid MRSA PCR on respiratory specimens from ventilated patients with suspected pneumonia: a tool to facilitate antimicrobial stewardship
- Source :
- Trevino, S E; Pence, M A; Marschall, Jonas; Kollef, M H; Babcock, H M; Burnham, C-A D (2017). Rapid MRSA PCR on respiratory specimens from ventilated patients with suspected pneumonia: a tool to facilitate antimicrobial stewardship. European journal of clinical microbiology & infectious diseases, 36(5), pp. 879-885. Springer 10.1007/s10096-016-2876-5
- Publication Year :
- 2016
-
Abstract
- Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of pneumonia in ventilated patients. Our objective was to evaluate the GeneXpert MRSA/SA SSTI Assay (Xpert MRSA/SA) (Cepheid, Sunnyvale, CA) for use in lower respiratory tract (LRT) specimens for rapid MRSA detection and to determine the potentially saved antibiotic-days if a culture-based identification method was replaced by this assay. Remnant LRT samples from ventilated patients submitted to the microbiology laboratory for routine culture were tested using conventional culture and Xpert MRSA/SA. One hundred of 310 LRT specimens met the inclusion criteria. Ten samples were positive for MRSA by Xpert MRSA/SA, while six were positive by routine culture methods. Xpert MRSA/SA correctly identified 5/6 positive and 89/94 negative MRSA specimens, for a sensitivity of 83.3%, specificity of 94.7%, positive predictive value of 45.6%, and negative predictive value of 98.9%. The assay also correctly detected 3/3 positive and 90/97 negative methicillin-susceptible S. aureus (MSSA) specimens, for a sensitivity of 100%, specificity of 92.8%, positive predictive value of 30%, and negative predictive value of 100%. A total of 748 vancomycin and 305 linezolid antibiotic-days were associated with the enrolled specimens. Vancomycin and linezolid utilization could decrease by 68.4% and 83%, respectively, if discontinued 1 day after negative polymerase chain reaction (PCR) results. The Xpert MRSA/SA SSTI rapid MRSA PCR assay performed well in respiratory samples from ventilated patients with suspected pneumonia and has the potential to facilitate stewardship efforts such as reducing empiric vancomycin and linezolid therapy.
- Subjects :
- 0301 basic medicine
Time Factors
medicine.disease_cause
Polymerase Chain Reaction
chemistry.chemical_compound
0302 clinical medicine
Medical microbiology
Medicine
030212 general & internal medicine
Prospective Studies
610 Medicine & health
Aged, 80 and over
GeneXpert MTB/RIF
Pneumonia, Ventilator-Associated
General Medicine
Middle Aged
Staphylococcal Infections
Anti-Bacterial Agents
Infectious Diseases
Molecular Diagnostic Techniques
Predictive value of tests
Vancomycin
medicine.drug
Microbiology (medical)
Adult
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty
Adolescent
030106 microbiology
Staphylococcal infections
Sensitivity and Specificity
03 medical and health sciences
Young Adult
Predictive Value of Tests
Internal medicine
Humans
Aged
Retrospective Studies
business.industry
biochemical phenomena, metabolism, and nutrition
medicine.disease
bacterial infections and mycoses
Methicillin-resistant Staphylococcus aureus
Drug Utilization
Surgery
Pneumonia
chemistry
Linezolid
business
Subjects
Details
- ISSN :
- 14354373
- Volume :
- 36
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- European journal of clinical microbiologyinfectious diseases : official publication of the European Society of Clinical Microbiology
- Accession number :
- edsair.doi.dedup.....54834b2201923b1e2b725434ca58d3bc