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PCR system may improve antibiotic selection in MRSA
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A novel PCR assay was associated with improvements in diagnostic turnaround time and appropriate antimicrobial use in a cohort of patients with methicillin-resistant Staphylococcus aureus.
Clinical challenges in treating abscesses in community-associated MRSA have led to poor antibiotic stewardship, according to the researchers. They added, specifically, that current diagnostic technology does not allow clinicians to predict when colonization will lead to infection.
The current study was a feasibility investigation of a rapid PCR system (GeneXpert, Cepheid) before patient discharge from a tertiary care, urban, academic ED.
Clinicians screened patients during an 18-week period. Thirty-two patients in the study group were assigned the PCR swab and 22 patients in a control group were assigned traditional care. Clinicians swabbed nasal and pharyngeal sites along with the superficial aspect of the wound, according to the findings.
Baseline demographic and clinical data were similar between the two groups. All results from the PCR analysis were available at discharge.
The turnaround time for nasal PCR swabs was 73 ± 7 minutes, whereas pharyngeal swabs required 82 ± 14 minutes and superficial wounds required 79 ± 17 minutes.
Both groups carried similar hospital stay durations.
A nonsignificant trend toward improvements in ideal antibiotic selection rates was reported in the PCR group (45% improvement; P=.08).
The researchers concluded that PCR swabs collected at triage may yield improved diagnostic turnaround times without affecting length of stay.
“Real-time determination of MRSA colonization may represent an opportunity to improve antibiotic selectivity in the treatment of abscesses,” the researchers wrote.
Disclosure: Cepheid provided material support in the form of a GeneXpert system and GeneXpert MRSA Nasal and MRSA/SA SSTI cartridges. Pulia received a speaking honorarium from Cepheid. However, Cepheid did not provide any content or editorial input for this manuscript.
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