|
AN EASY WAY TO DETERMINE RISK FOR MRSA/VRE CARRIAGE
|
Key Point
|
| Patients at high risk of colonization with either MRSA or VRE can be easily identified at hospital admission. |
BALTIMORE—Studies have indicated that previous hospitalization and exposure to antibiotics are associated with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) carriage in patients at hospital admission. To quantify these variables, researchers from the University of Maryland designed and tested a clinical prediction rule that would identify patients at high risk for colonization with MRSA or VRE as part of routine hospital admission procedure.1
Patients were enrolled between December 16, 2003, and September 9, 2004, and given a questionnaire that obtained information about hospital admissions and antibiotic use outside of the study hospital during the past year. Within 24 hours of enrollment, a study nurse collected specimens from the anterior nares and perirectal regions for culturing.
Data from 699 patients were included. Of all anterior nares cultures, 175 (25.1%) were positive for S aureus, and 49 of these yielded MRSA, making the prevalence 7%. Of 555 perirectal cultures, MRSA was isolated from six (1.1%), while VRE was detected in 29 (5.2%).
Three hundred fifty-two patients were identified by the study hospital’s data repository as having been admitted to that hospital during the previous year. An additional 105 patients who had been hospitalized elsewhere were identified from the questionnaire. The authors noted that these 105 patients would not have been detected by the hospital’s automated computer system. Likewise, the hospital identified 39.5% of patients as having received antibiotics within the past year, but questionnaire responses suggested that actual antibiotic exposure was 68.7%.
The prediction rule for colonization with either MRSA or VRE requires patients to have been hospitalized and to have received antibiotics during the previous year. Use of these two criteria identified 76% of patients colonized with MRSA, 100% of patients colonized with VRE, and 90% of patients who were colonized with either organism.
"These data suggest that a high proportion of patients who were previously unrecognized carriers are colonized with MRSA or VRE on hospital admission," the investigators concluded.
—Gale Jurasek
Reference
1. Furuno JP, McGregor JC, Harris AD, et al. Identifying groups at high risk for carriage of antibiotic-resistant bacteria. Arch Intern Med. 2006;166:580-585.
Return
to table of contents
|
