Methicillin-resistant Staphylococcus aureus risk profiling: who are we missing?

Antimicrobial Resistance and Infection Control

Anne Iten⁴  Arnaud Perrier⁵  Didier Pittet⁴  Gilles Cohen¹  Jacques Schrenzel²  Veronique Camus⁴  Thibaud Koessler⁵  Stephan Harbarth⁴  Janet Pasricha³ 

[1]Direction of Medico-Economic Analysis, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland

[2]Central Laboratory of Bacteriology, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland

[3]Current affiliation: The Jenner Institute, Oxford University, Oxford, UK

[4]Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle Perret-Gentil, Geneva 1211, Switzerland

[5]Department of General Internal Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland

关键词: Switzerland;    Staphylococcal infection;    Predictive value of tests;    Probability;    Prevalence;    MRSA;    Epidemiology;    Carrier state;   

Others  :  790835
DOI  :  10.1186/2047-2994-2-17

 received in 2013-03-04, accepted in 2013-05-26,  发布年份 2013

【 摘 要 】

Background

Targeted screening of patients at high risk for methicillin-resistant Staphylococcus aureus (MRSA) carriage is an important component of MRSA control programs, which rely on prediction tools to identify those high-risk patients. Most previous risk studies reported a substantial rate of patients who are eligible for screening, but failed to be enrolled. The characteristics of these missed patients are seldom described. We aimed to determine the rate and characteristics of patients who were missed by a MRSA screening programme at our institution to see how the failure to include these patients might impact the accuracy of clinical prediction tools.

Findings

From March-June 2010 all patients admitted to 13 internal medicine wards at the University of Geneva Hospital (HUG) were prospectively screened for MRSA carriage. Of 1968 patients admitted to the ward, 267 patients (13.6%) failed to undergo appropriate MRSA screening. Forty-one (2.4%) screened patients were MRSA carriers at admission. On multivariate regression, patients who were missed by screening were more likely to be aged < 50 years (OR 2.4 [1.4-3.9]), transferred to internal medicine from another ward in the hospital (OR 2.8 [1.1-7.1]), and have a history of malignancy (OR 3.2[2.1-5.1]). There was no significant difference in the rate of previous MRSA carriage between screened and unscreened patients.

Conclusions

Our findings highlight the potential bias that “missed” patients may introduce into MRSA risk scores. Reporting on the proportions and characteristics of missed patients is essential for accurate interpretation of MRSA prediction tools.

【 授权许可】

   
2013 Pasricha et al.; licensee BioMed Central Ltd.

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