Active surveillance of the trachea or throat for MRSA is more sensitive than nasal surveillance and a better predictor of MRSA infections among patients in intensive care.

<h4>Background</h4>Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common causes of infection in the intensive care unit (ICU). Although surveillance culture for MRSA is recommended for ICU patients, no comparative study investigating the optimal sites and frequency...

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Autores principales:	Hee-Chang Jang, Ok-Ja Choi, Gwang-Sook Kim, Mi-Ok Jang, Seung-Ji Kang, Sook-In Jung, Jong-Hee Shin, Byeong Jo Chun, Kyung-Hwa Park
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d3a03220012f465190c5b13f6f9be61f
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spelling	oai:doaj.org-article:d3a03220012f465190c5b13f6f9be61f2021-11-18T08:16:34ZActive surveillance of the trachea or throat for MRSA is more sensitive than nasal surveillance and a better predictor of MRSA infections among patients in intensive care.1932-620310.1371/journal.pone.0099192https://doaj.org/article/d3a03220012f465190c5b13f6f9be61f2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24911358/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common causes of infection in the intensive care unit (ICU). Although surveillance culture for MRSA is recommended for ICU patients, no comparative study investigating the optimal sites and frequency of culture has been performed in this population.<h4>Methods</h4>A prospective observational cohort study was performed in an 18-bed emergency intensive care unit (EICU) in a tertiary teaching hospital. A total of 282 patients were included. Samples for MRSA detection were obtained at the time of admission, 48 h after admission, and then weekly thereafter. All subjects were routinely monitored for the development of MRSA infection during their stay in the ICU.<h4>Results</h4>MRSA colonization was detected in 129 (46%) patients over the course of the study. The sensitivity of MRSA surveillance culture was significantly higher in throat or tracheal aspirates (82%; 106/129) than in anterior nares (47%; 61/129) (P<0.001). The sensitivity of MRSA surveillance culture for subsequent MRSA infection and MRSA pneumonia was also higher in the throat/trachea (69 and 93%, respectively) than in the anterior nares (48 and 50%, respectively). The area under the curve for subsequent MRSA infection was higher in trachea/throat (0.675) than in the anterior nares (0.648); however, this difference was not significant (P>0.05). The area under the curve for MRSA pneumonia was significantly higher in trachea/throat (0.791; 95% CI, 0.739-0.837) than anterior nares (0.649; 95% CI, 0.590-0.705) (P = 0.044).<h4>Conclusion</h4>MRSA colonization was more common in the trachea/throat than in the anterior nares in ICU patients. Cultures from throat or tracheal aspirates were more sensitive and predictive of subsequent MRSA pneumonia than cultures from the anterior nares in this population.Hee-Chang JangOk-Ja ChoiGwang-Sook KimMi-Ok JangSeung-Ji KangSook-In JungJong-Hee ShinByeong Jo ChunKyung-Hwa ParkPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 6, p e99192 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hee-Chang Jang Ok-Ja Choi Gwang-Sook Kim Mi-Ok Jang Seung-Ji Kang Sook-In Jung Jong-Hee Shin Byeong Jo Chun Kyung-Hwa Park Active surveillance of the trachea or throat for MRSA is more sensitive than nasal surveillance and a better predictor of MRSA infections among patients in intensive care.
description	<h4>Background</h4>Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common causes of infection in the intensive care unit (ICU). Although surveillance culture for MRSA is recommended for ICU patients, no comparative study investigating the optimal sites and frequency of culture has been performed in this population.<h4>Methods</h4>A prospective observational cohort study was performed in an 18-bed emergency intensive care unit (EICU) in a tertiary teaching hospital. A total of 282 patients were included. Samples for MRSA detection were obtained at the time of admission, 48 h after admission, and then weekly thereafter. All subjects were routinely monitored for the development of MRSA infection during their stay in the ICU.<h4>Results</h4>MRSA colonization was detected in 129 (46%) patients over the course of the study. The sensitivity of MRSA surveillance culture was significantly higher in throat or tracheal aspirates (82%; 106/129) than in anterior nares (47%; 61/129) (P<0.001). The sensitivity of MRSA surveillance culture for subsequent MRSA infection and MRSA pneumonia was also higher in the throat/trachea (69 and 93%, respectively) than in the anterior nares (48 and 50%, respectively). The area under the curve for subsequent MRSA infection was higher in trachea/throat (0.675) than in the anterior nares (0.648); however, this difference was not significant (P>0.05). The area under the curve for MRSA pneumonia was significantly higher in trachea/throat (0.791; 95% CI, 0.739-0.837) than anterior nares (0.649; 95% CI, 0.590-0.705) (P = 0.044).<h4>Conclusion</h4>MRSA colonization was more common in the trachea/throat than in the anterior nares in ICU patients. Cultures from throat or tracheal aspirates were more sensitive and predictive of subsequent MRSA pneumonia than cultures from the anterior nares in this population.
format	article
author	Hee-Chang Jang Ok-Ja Choi Gwang-Sook Kim Mi-Ok Jang Seung-Ji Kang Sook-In Jung Jong-Hee Shin Byeong Jo Chun Kyung-Hwa Park
author_facet	Hee-Chang Jang Ok-Ja Choi Gwang-Sook Kim Mi-Ok Jang Seung-Ji Kang Sook-In Jung Jong-Hee Shin Byeong Jo Chun Kyung-Hwa Park
author_sort	Hee-Chang Jang
title	Active surveillance of the trachea or throat for MRSA is more sensitive than nasal surveillance and a better predictor of MRSA infections among patients in intensive care.
title_short	Active surveillance of the trachea or throat for MRSA is more sensitive than nasal surveillance and a better predictor of MRSA infections among patients in intensive care.
title_full	Active surveillance of the trachea or throat for MRSA is more sensitive than nasal surveillance and a better predictor of MRSA infections among patients in intensive care.
title_fullStr	Active surveillance of the trachea or throat for MRSA is more sensitive than nasal surveillance and a better predictor of MRSA infections among patients in intensive care.
title_full_unstemmed	Active surveillance of the trachea or throat for MRSA is more sensitive than nasal surveillance and a better predictor of MRSA infections among patients in intensive care.
title_sort	active surveillance of the trachea or throat for mrsa is more sensitive than nasal surveillance and a better predictor of mrsa infections among patients in intensive care.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/d3a03220012f465190c5b13f6f9be61f
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Active surveillance of the trachea or throat for MRSA is more sensitive than nasal surveillance and a better predictor of MRSA infections among patients in intensive care.

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