Comparing a single-day swabbing regimen with an established 3-day protocol for MRSA decolonization control

June 12, 2018 at 8:15 am

Clinical Microbiology abd Infection May 2018 V.24 N.5 P.522–527

Frickmann, N.G. Schwarz, A. Hahn, A. Ludyga, P. Warnke, A. Podbielski

Objectives

Success of methicillin-resistant Staphylococcus aureus (MRSA) decolonization procedures is usually verified by control swabs of the colonized body region. This prospective controlled study compared a single-day regimen with a well-established 3-day scheme for noninferiority and adherence to the testing scheme.

Methods

Two sampling schemes for screening MRSA patients of a single study cohort at a German tertiary-care hospital 2 days after decolonization were compared regarding their ability to identify MRSA colonization in throat or nose. In each patient, three nose and three throat swabs were taken at 3- to 4-hour intervals during screening day 1, and in the same patients once daily on days 1, 2 and 3. Swabs were analysed using chromogenic agar and broth enrichment. The study aimed to investigate whether the single-day swabbing scheme is not inferior to the 3-day scheme with a 15% noninferiority margin.

Results

One hundred sixty patients were included, comprising 105 and 101 patients with results on all three swabs for decolonization screening of the nose and throat, respectively. Noninferiority of the single-day swabbing scheme was confirmed for both pharyngeal and nasal swabs, with 91.8% and 89% agreement, respectively. The absolute difference of positivity rates between the swabbing regimens was 0.025 (−0.082, 0.131) for the nose and 0.006 (−0.102, 0.114) (95% confidence interval) for the pharynx as calculated with McNemar’s test for matched or paired data. Compliance with the single-day scheme was better, with 12% lacking second-day swabs and 27% lacking third-day swabs from the nostrils.

Conclusions

The better adherence to the single-day screening scheme with noninferiority suggests its implementation as the new gold standard.

FULL TEXT

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(17)30480-9/fulltext

PDF

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(17)30480-9/pdf

Advertisements

Entry filed under: Epidemiología, Health Care-Associated Infections, Infecciones nosocomiales, Metodos diagnosticos, REPORTS, Resistencia bacteriana, Update.

Selective digestive and oropharyngeal decontamination in medical and surgical ICU patients: individual patient data meta-analysis Comparative safety of dolutegravir-based or efavirenz-based antiretroviral treatment started during pregnancy in Botswana: an observational study.


Calendar

June 2018
M T W T F S S
« May   Jul »
 123
45678910
11121314151617
18192021222324
252627282930  

Most Recent Posts


%d bloggers like this: