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MRSA screening on a paediatric intensive care unit
  1. James Gray1,
  2. Mitul Patel1,
  3. Helen Turner1,
  4. Fiona Reynolds2
  1. 1Department of Microbiology, Birmingham Children's Hospital, Birmingham, UK
  2. 2Paediatric Intensive Care Unit, Birmingham Children's Hospital, Birmingham, UK
  1. Correspondence to James Gray, Department of Microbiology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK; jim.gray{at}bch.nhs.uk

Abstract

The accuracies of chromogenic agar and the GeneXpert real-time PCR system (Cepheid, Sunnyvale, California, USA) for admission methicillin-resistant Staphylococcus aureus (MRSA) screening of 1336 consecutive paediatric intensive care unit patients (1282 evaluable swab results) were determined using enrichment culture as the reference standard. Twenty (1.6%) swabs were MRSA-positive by enrichment culture (reference test). PCR was more sensitive (0.9, 95% CI 0.68 to 0.99 vs 0.65, 95% CI 0.41 to 0.85) but less specific (0.98, 95% CI 0.98 to 0.99 vs 100%) than chromogenic agar. After introduction of screening no patient developed MRSA infection or acquired MRSA after admission. In the preceding 3 years of screening, 16 patients had MRSA diagnosed after admission, nine presenting with infection. The accuracy of PCR was comparable to previous studies, but the positive predictive value in a low prevalence paediatric population was only 0.49. Screening provided some clinical benefits, to which the early availability of PCR results may have contributed.

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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