Impact of methicillin‐resistant Staphylococcus aureus polymerase chain reaction nasal swabs on vancomycin utilisation in patients admitted to the intensive care unit with respiratory infections

Abstract

AbstractBackgroundMethicillin‐resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR) screening has a negative predictive value as high as 96% for pneumonia. Using nasal PCR, care providers can detect the presence or absence of MRSA earlier and potentially decrease the duration of vancomycin therapy in patients with negative results.AimsThe primary objective was to assess the impact of MRSA nasal PCR on vancomycin length of therapy in patients admitted to the intensive care unit (ICU) with respiratory infections.MethodsThis was a retrospective, quasi‐experimental, uncontrolled before—after study, comparing patients receiving screening versus those who did not. Patients over the age of 18, admitted to ICU with respiratory infections who received at least one dose of vancomycin were included in this study. This investigation received exemption from the South Nassau Communities Hospital and Western Institutional Review Board (reference number SNCH‐E14) and was conducted in accordance with the tenets espoused in the Declaration of Helsinki.ResultsA total of 77 patients, 22 in the study group and 55 in the comparator group were included in the analysis. There was a reduction in median length of vancomycin therapy in the MRSA PCR group compared to the unscreened group (1.7 days vs. 6 days, IQR: 4.15 vs. 4.8, p < 0.001). There was a reduction in median vancomycin levels performed (3 levels vs. 1 level, p = 0.619).ConclusionsThe use of nasal PCR screening for MRSA was associated with a reduction in median vancomycin length of therapy for patients admitted to the ICU with respiratory infections.