Predictive Role of Targeted, Active Surveillance Cultures for Detection of Methicillin-Resistant Staphylococcus aureus
Safiya Al Musawi,1 Qassim Alkhaleefa,2 Samia Alnassri,3 Aisha Alamri,4 Amani Alnimr2 1Department of Pathology, Salmaniya Medical Complex, Ministry of Health, Manama, Kingdom of Bahrain; 2Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2021
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| Acceso en línea: | https://doaj.org/article/9f6436db5a084401aece8c998f21a6e8 |
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| Sumario: | Safiya Al Musawi,1 Qassim Alkhaleefa,2 Samia Alnassri,3 Aisha Alamri,4 Amani Alnimr2 1Department of Pathology, Salmaniya Medical Complex, Ministry of Health, Manama, Kingdom of Bahrain; 2Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia; 3Department of Infection Control, King Fahad Hospital of the University, Dammam, Kingdom of Saudi Arabia; 4Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi ArabiaCorrespondence: Amani AlnimrDepartment of Microbiology, College of Medicine, Imam Abdul Rahman Bin Faisal University, P.O. Box 1982, Dammam, 31441, Kingdom of Saudi ArabiaTel +966 56 318 1019Email amalnimr@iau.edu.saAisha AlamriDepartment of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdul Rahman Bin Faisal University, Dammam, 3144, Kingdom of Saudi ArabiaTel +966 538187263Email aiamri@iau.edu.saIntroduction: Methicillin-resistant Staphylococcus aureus (MRSA) colonisation is an important source of healthcare-acquired infections. Reliable screening strategies for MRSA colonisation are essential for the timely implementation of infection control measures.Aim: This study determined reliable MRSA screening sites to predict colonisation in resource-limited settings and estimated the impact of missed MRSA cases when shifting from multi- to single-site screening.Methodology: A cross-sectional study was conducted in patients with positive MRSA surveillance cultures from the routinely screened sites (nasal, axillary, groin, and throat) from January 2009 to December 2019.Results: A total of 1906 screening tests were positive for MRSA cultures (n = 1345 patients). As a single site, the nasal cavity showed the highest MRSA detection, with a sensitivity of 66.8% (95% CI = 64– 69) with 277.9 missed isolation days. Screening three or more anatomical sites detected 97– 100% of MRSA cases, with 0– 24.5 missed isolation days. Screening the axilla and groin separately or in combination showed a good clinical utility index (CUI) of > 0.6 to < 0.8, while an excellent CUI was obtained upon screening other site samples (> 0.8). The combined nasal and throat cultures demonstrated a sensitivity of 93.2 (95% CI = 91– 94) with 57.2 missed isolation days.Conclusion: Multi-site screening is the optimal strategy for minimising MRSA exposure within a healthcare facility. For active MRSA surveillance, a combination of nasal and throat cultures can provide a practical approach in low-resource settings compared to nasal sampling alone.Keywords: methicillin-resistant Staphylococcus aureus, screening sites, infection control, Saudi Arabia |
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