Reviewed by Zach Willis, MD, MPH, UNC School of Medicine
The utility of MRSA surveillance has been established in adults, but very few studies have addressed this issue in pediatric patients. In this study by Diseroad, et al., the researchers’ institution routinely obtained MRSA surveillance cultures on pediatric patients admitted to the ICU and weekly thereafter. They reviewed 165 patients who had a negative initial MRSA surveillance culture and went on to have an evaluation for infection and empiric therapy with anti-MRSA coverage during the same hospitalization. In that sample, a single patient screened negative for MRSA and subsequently developed an MRSA infection, for an estimated negative predictive value of 99.4%. Meanwhile, of those 165 patients, 72 (43.6%) had a positive culture for MSSA; in comparison, they report that about 40% of Staphylococcus aureus isolates in their hospital are MRSA. While further study is needed, prospective MRSA surveillance may provide a mechanism to reduce use of empiric anti-MRSA therapy in children’s hospitals.
Diseroad ER, Tamma PD, Same RG, Hsu AJ. The Clinical Utility of MRSA Nasal Surveillance Swabs in Ruling-Out MRSA Infections in Children. Journal of the Pediatric Infectious Diseases Society. Published online February 22, 2023:piad011. doi:10.1093/jpids/piad011