scholarly journals Predictive Value of Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Swab PCR Assay for MRSA Pneumonia

2013 ◽  
Vol 58 (2) ◽  
pp. 859-864 ◽  
Author(s):  
Benjamin Dangerfield ◽  
Andrew Chung ◽  
Brandon Webb ◽  
Maria Teresa Seville
Keyword(s):  
Staphylococcus Aureus ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Nasal Swab ◽  
Care Center ◽  
Tertiary Care ◽  
Active Agent ◽  
Pcr Assay ◽  
Methicillin Resistant

ABSTRACTPneumonia due to methicillin-resistantStaphylococcus aureus(MRSA) is associated with poor outcomes and frequently merits empirical antibiotic consideration despite its relatively low incidence. Nasal colonization with MRSA is associated with clinical MRSA infection and can be reliably detected using the nasal swab PCR assay. In this study, we evaluated the performance of the nasal swab MRSA PCR in predicting MRSA pneumonia. A retrospective cohort study was performed in a tertiary care center from January 2009 to July 2011. All patients with confirmed pneumonia who had both a nasal swab MRSA PCR test and a bacterial culture within predefined time intervals were included in the study. These data were used to calculate sensitivity, specificity, positive predictive value, and negative predictive value for clinically confirmed MRSA pneumonia. Four hundred thirty-five patients met inclusion criteria. The majority of cases were classified as either health care-associated (HCAP) (54.7%) or community-acquired (CAP) (34%) pneumonia. MRSA nasal PCR was positive in 62 (14.3%) cases. MRSA pneumonia was confirmed by culture in 25 (5.7%) cases. The MRSA PCR assay demonstrated 88.0% sensitivity and 90.1% specificity, with a positive predictive value of 35.4% and a negative predictive value of 99.2%. In patients with pneumonia, the MRSA PCR nasal swab has a poor positive predictive value but an excellent negative predictive value for MRSA pneumonia in populations with low MRSA pneumonia incidence. In cases of culture-negative pneumonia where initial empirical antibiotics include an MRSA-active agent, a negative MRSA PCR swab can be reasonably used to guide antibiotic de-escalation.

scholarly journals Evaluation of the Scoring Systems to Differentiate between Benign and Malignant Adnexal Masses in a Tertiary Care Center, Pune

2013 ◽  
Vol 5 (3) ◽  
pp. 135-138
Author(s):  
Shilpa Nitin Chaudhari ◽  
Poorva Niteen Deshpande ◽  
Priyanka Rohit Gupta ◽  
Tanvi Rajeev Warty ◽  
Devika Bharat Bhikane
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Care Center ◽  
Tertiary Care ◽  
Scoring Systems ◽  
Tertiary Care Center ◽  
Adnexal Masses ◽  
System Sensitivity

ABSTRACT Objective The aim of this study was to evaluate the scoring systems to differentiate between benign and malignant adnexal masses. Methods It is a prospective study carried on 60 women at a tertiary care center. Transabdominal ultrasonography and color Doppler was done and women were followed till resolution of symptoms. Gold standard for diagnosis of adenexal masses was histopathological examination of specimen or fluid cytology. Results Efficacy of Sassone scoring system for diagnosing malignant tumors sensitivity 75%, specificity 90.91%, positive predictive value 75%, negative predictive value 90.91% and an accuracy of 86.67%. Efficacy of De Priest scoring system sensitivity 66.67%, specificity 100%, positive predictive value 100%, negative predictive value 92.31% and an accuracy of 93.33%. Efficacy of Ferrazzi scoring system sensitivity 75%, specificity 100%, positive predictive value 100%, negative predictive value 91.67%, and an accuracy of 93.33%. Efficacy of alcazar scoring system sensitivity 100%, specificity 100%, Positive predictive value 100%, negative predictive value 100%, and an accuracy of 100%. Conclusion Alcazar scoring system was found to be more sensitive and specific than other available scoring systems. How to cite this article Chaudhari SN, Deshpande PN, Gupta PR, Warty TR, Bhikane DB. Evaluation of the Scoring Systems to Differentiate between Benign and Malignant Adnexal Masses in a Tertiary Care Center, Pune. J South Asian Feder Obst Gynae 2013;5(3):135-138.

Rapid Detection of Methicillin-Resistant Staphylococcus aureus (MRSA) and Methicillin-Susceptible Staphylococcus aureus (MSSA) Using the KeyPath MRSA/MSSA Blood Culture Test and the BacT/ALERT System in a Pediatric Population

2013 ◽  
Vol 137 (8) ◽  
pp. 1103-1105 ◽  
Author(s):  
Kaede V. Sullivan ◽  
Nicole N. Turner ◽  
Sylvester S. Roundtree ◽  
Karin L. McGowan
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Blood Cultures ◽  
Methicillin Resistant ◽  
Culture Test ◽  
Sensitivity Specificity ◽  
Gram Positive Cocci

Context.—Timely initiation of directed antimicrobial therapy for Staphylococcus aureus bacteremia is dependent on rapid identification of S aureus to ascertain methicillin-susceptibility status. Objectives.—To investigate the performance of the rapid KeyPath (MicroPhage, Inc, Longmont, Colorado) methicillin-resistant S aureus (MRSA) and methicillin-susceptible S aureus (MSSA) blood culture test (MMBT). Design.—Positive BacT/ALERT Pediatric FAN (fastidious antibiotic neutralization) blood culture bottles (bioMérieux, Inc, Durham, North Carolina) were tested prospectively using MMBT and routine bacterial identification and antibiotic susceptibility testing procedures as the gold standard. The MMBT uses an S aureus–specific bacteriophage cocktail that infects bacterial cells and replicates them, resulting in cellular lysis. Bacteriophage-specific antibodies detect the increase in bacteriophage concentration in an immunoassay device. Phage amplification, in both the presence and absence of cefoxitin, indicates the presence of MRSA. The sensitivity, specificity, positive predictive value, and negative predictive value of MMBT in detecting S aureus, MSSA, and MRSA were calculated. Results.—Of 188 positive blood cultures tested, 199 (63%) had Gram-positive cocci in clusters, 46 (24%) grew S aureus (26 MSSA [57%], 20 MRSA [43%]) with the MMBT detecting 40 of 46 (87%). The sensitivity, specificity, positive predictive value, and negative predictive value among blood cultures with Gram-positive cocci in clusters were 87%, 100%, 100%, and 92% for S aureus; 81%, 100%, 100%, and 95% for MSSA; and 95%, 100%, 100%, and 99% for MRSA. All blood cultures without growth of S aureus tested negative by MMBT. Conclusions.—The MMBT detected MSSA and MRSA directly from positive BacT/ALERT PF bottles with positive predictive values of 100%, suggesting that positive results could be reported immediately, but the sensitivity of this assay limited immediate reporting of negative results.

scholarly journals 247. The Predictive Value of Methicillin-Resistant Staphylococcus aureus Surveillance Swabs in Septic Arthritis

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S231-S232
Author(s):  
Samuel Harder ◽  
Kwame Asiamah ◽  
Geoffrey Shumilak ◽  
Beverly J Wudel
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Positive Predictive Value ◽  
Septic Arthritis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Causative Pathogen ◽  
Methicillin Resistant ◽  
Rule Out

Abstract Background Septic arthritis is a destructive form of acute arthritis secondary to infection. With an annual incidence of 2 to 5 cases per 100 000 individuals, it is associated with significant morbidity and mortality. Prompt source control and antimicrobial therapy remain the mainstays of management. Epidemiology, microbiology studies, and local resistance patterns are important in guiding therapeutic decisions. Staphylococcal and streptococcal species are the most common pathogens with Methicillin-resistant Staphylococcus aureus (MRSA) becoming an increasingly important pathogen. The increasing incidence of MRSA provides clinicians with the challenge of deciding which patients require empiric coverage for MRSA. MRSA nasal screening has been shown to have a high negative predictive value in pneumonia, bloodstream infections, and nosocomial infections in critically ill patients. However, little is known about the diagnostic utility of MRSA surveillance swabs for predicting MRSA infections in septic arthritis. Methods A retrospective cohort study was performed in 3 tertiary hospitals from September 1, 2010 to December 31, 2020. All adult patients with confirmed septic arthritis of the ankle, wrist, knee, or hip and an MRSA surveillance swab performed within 72 hours of admission were included in the study. These data were used to calculate the sensitivity, specificity, positive predictive value and negative predictive value for MRSA surveillance swabs. Results One hundred seventy-two patients met inclusion criteria. Thirty patients had positive MRSA surveillance swabs. The prevalence of MRSA in joint cultures was 11.04%. The positive predictive value of MRSA surveillance swabs was 42.3% and the negative predictive value was 93.5% in all participants. The MRSA surveillance swab had a negative predictive value of 100% in participants with no risk factors for MRSA colonization. Conclusion The negative predictive value of MRSA surveillance swabs used independently is insufficient to confidently rule out MRSA as the causative pathogen in septic arthritis. When used in combination with MRSA risk factors, the absence of MRSA risk factors may help clinicians rule out MRSA as a causative pathogen. Disclosures All Authors: No reported disclosures

Evaluation of the negative predictive value of methicillin-resistant Staphylococcus aureus nasal swab screening in patients with acute myeloid leukemia

2020 ◽  
pp. 1-4
Author(s):  
Sarah K. Perreault ◽  
Bailee Binks ◽  
Dayna S. McManus ◽  
Jeffrey E. Topal
Keyword(s):  
Staphylococcus Aureus ◽  
Acute Myeloid Leukemia ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Myeloid Leukemia ◽  
Nasal Swab ◽  
Nasal Swabs ◽  
Mrsa Infection ◽  
Acute Myeloid

Abstract Objective: Methicillin-resistant Staphylococcus aureus (MRSA) nasal swabs are utilized to guide the discontinuation of empiric MRSA therapy. In multiple studies, MRSA nasal swabs have been shown to have a negative predictive value (NPV) of ~99% in non-oncology patients with pneumonia and other infections. We evaluated the performance characteristics of a negative MRSA nasal swab in the acute myeloid leukemia (AML) populaion to determine its NPV. Design: Retrospective chart review. Patients: This study included adult AML patients with a suspected infection and a MRSA nasal swab collected between 2013 and 2018. Methods: MRSA nasal swab and culture-documented infections were identified to determine the sensitivity, specificity, NPV, and positive predictive value of the MRSA nasal swabs. Results: In total, 194 patients were identified, and 484 discrete encounters were analyzed. Overall, 468 (97%) encounters had a negative MRSA nasal swab upon admission with no cultured documented MRSA infection during their hospitalization. However, 3 encounters (0.6%) had a negative MRSA nasal swab with a subsequent cultured documented MRSA infection during their admission. Identified infections were bacteremia (n = 2) and confirmed pneumonia (n = 1). MRSA nasal swab had a sensitivity of 62% (95% CI, 0.24–0.91), specificity of 98% (95% CI, 0.96–0.99), positive predictive value of 38% (95% CI, 0.21–0.6), and NPV of 99% (95% CI, 0.98–1). Conclusions: A negative MRSA nasal swab has a 99% NPV for subsequent MRSA infections in AML patients with no prior history of MRSA colonization or infection. Based on these findings, a negative MRSA nasal swab can help guide de-escalation of empiric MRSA antibiotic therapy.

COMPARATIVE STUDY OF E-STRIP AND VITEK 2 FOR VANCOMYCIN MIC FOR STAPHYLOCOCCUS AUREUS AT TERTIARY CARE CENTER

2021 ◽  
pp. 8-10
Author(s):  
Gauri Thakare ◽  
Sonal Chavan ◽  
Sharmila Raut ◽  
Rajani Tore ◽  
Ravindra Khadse
Keyword(s):  
Staphylococcus Aureus ◽  
Comparative Study ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Care Center ◽  
Tertiary Care ◽  
Test Material ◽  
Methicillin Resistant ◽  
Study Results ◽  
Vitek 2 ◽  
Strip Test

PURPOSE: Comparative Study done for Vancomycin susceptibility in Methicillin Resistant Staphylococcus aureus (MRSA) in two methods Vitek-2 and E-strip test. MATERIAL AND METHOD: Vancomycin susceptibility testing was performed on these Methicillin Resistant Staphylococcus aureus (MRSA) isolates by two methods viz. Vitek 2 & E- strip Test. RESULT: A total of 10680 various specimens were received and processed in laboratory. 210 samples were S. aureus amongst which 76 were MRSAs. Pus was the predominant sample followed by endotracheal secretions, blood, and sputum. All the strains of MRSA found susceptible to vancomycin (MIC≤ 2µg/ ml) by both the methods. Maximum specimens by both the methods had MICs of 1.0 µg/ ml. CONCLUSION: In the present study results of Vitek and E-strip were almost comparable. In the advanced era of automation and computerized technology with manpower compromised labs, Vitek could be a better option for vancomycin MIC.

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