FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4387249274> ?p ?o ?g. }

• W4387249274 endingPage "A1647" @default.
• W4387249274 startingPage "A1647" @default.
• W4387249274 abstract "SESSION TITLE: Improving ICU Practices SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/10/2023 12:55 pm - 01:40 pm PURPOSE: MRSA (Methicillin-resistant Staphylococcus aureus) pneumonia remains a significant healthcare hazard, and MRSA nasal culture and PCR has been used to predict the likelihood of MRSA infections in patients. They are credited with having a robust negative predictive value and allowing safe discontinuation of antibiotics. However, this de-escalation strategy has been compromised by the advent of universal decolonization practices, involving a multiday regimen of intranasal mupirocin or alcohol based nasal sanitizer. A recent study demonstrated intranasal mupirocin application prior to nasal MRSA PCR screening significantly reduced the NPV (negative predictive value), and often led to false negative results. We aimed to determine the reliability of MRSA nasal culture screen to de-escalate therapy in the setting of universal decolonization using ethyl alcohol. METHODS: A retrospective observational cohort study was conducted at a tertiary community teaching hospital, using a 62% ethanol solution intranasally for decolonisation per protocol. Cases were identified through the electronic medical records and list of patients who underwent MRSA nasal culture screen were identified. Patients who met inclusion criteria were identified and demographic and necessary clinical data were obtained. They were divided into two groups based on whether or not they received decolonisation. Data was analyzed for the primary outcome to determine NPV of the MRSA nasal culture screen with and without intranasal ethanol administration. RESULTS: 505 cases were screened, and 128 subjects included in the study. 102 of them received decolonization prior to obtaining the MRSA nasal culture while 26 did not. Baseline characteristics were well-balanced between both groups. Overall MRSA infection prevalence was 31.25%, with MRSA pneumonia being predominant. 19 out of 102 in the decolonization group had a positive MRSA growth from blood or sputum despite a negative MRSA nasal culture screen; whereas 5 out of 26 had similar results in the other group. The NPV in the group receiving decolonization before the screen was 73% while it was 80% in the group that was not decolonized. PPV was found to be 63% in the group receiving decolonization which was lower as compared to 100% in the group without decolonization. There was also a higher specificity but lower sensitivity of the MRSA nasal culture screen in the decolonisation group. 9 patients in the decolonization group required re-escalation of antibiotics after initial discontinuation after culture results, compared to nil in the other group. CONCLUSIONS: Our study shows that culture-based MRSA nasal screens are less accurate than previously reported PCR tests, as administration of ethyl alcohol leads to false negative results with the organisms becoming non-viable. A lower NPV in the decolonisation group predisposes to increased false negative results, leading to inappropriate antibiotic de-escalation and often requiring re-initiation. MRSA nasal culture screen is less reliable if alcohol has already been administered for decolonization and cannot be used as an appropriate tool to guide antibiotic de-escalation. CLINICAL IMPLICATIONS: In the setting of universal decolonization, caution should be used when de-escalating antibiotics based on MRSA nasal culture screen results only. The overall clinical condition of the patient and additional culture data should be taken into consideration. DISCLOSURES: No relevant relationships by Erin O'Shea Paudel No relevant relationships by Arunava Saha" @default.
• W4387249274 created "2023-10-03" @default.
• W4387249274 creator A5055086169 @default.
• W4387249274 creator A5082149556 @default.
• W4387249274 date "2023-10-01" @default.
• W4387249274 modified "2023-10-03" @default.
• W4387249274 title "MRSA NASAL SCREEN IN THE SETTING OF UNIVERSAL DECOLONIZATION: AN EMERGING DIAGNOSTIC DILEMMA" @default.
• W4387249274 doi "https://doi.org/10.1016/j.chest.2023.07.1132" @default.
• W4387249274 hasPublicationYear "2023" @default.
• W4387249274 type Work @default.
• W4387249274 citedByCount "0" @default.
• W4387249274 crossrefType "journal-article" @default.
• W4387249274 hasAuthorship W4387249274A5055086169 @default.
• W4387249274 hasAuthorship W4387249274A5082149556 @default.
• W4387249274 hasBestOaLocation W43872492741 @default.
• W4387249274 hasConcept C126322002 @default.
• W4387249274 hasConcept C141071460 @default.
• W4387249274 hasConcept C167135981 @default.
• W4387249274 hasConcept C177713679 @default.
• W4387249274 hasConcept C187212893 @default.
• W4387249274 hasConcept C194828623 @default.
• W4387249274 hasConcept C203014093 @default.
• W4387249274 hasConcept C2777052132 @default.
• W4387249274 hasConcept C2778246068 @default.
• W4387249274 hasConcept C2778311950 @default.
• W4387249274 hasConcept C2778715236 @default.
• W4387249274 hasConcept C2779489039 @default.
• W4387249274 hasConcept C2781413609 @default.
• W4387249274 hasConcept C523546767 @default.
• W4387249274 hasConcept C54355233 @default.
• W4387249274 hasConcept C71924100 @default.
• W4387249274 hasConcept C85663871 @default.
• W4387249274 hasConcept C86803240 @default.
• W4387249274 hasConceptScore W4387249274C126322002 @default.
• W4387249274 hasConceptScore W4387249274C141071460 @default.
• W4387249274 hasConceptScore W4387249274C167135981 @default.
• W4387249274 hasConceptScore W4387249274C177713679 @default.
• W4387249274 hasConceptScore W4387249274C187212893 @default.
• W4387249274 hasConceptScore W4387249274C194828623 @default.
• W4387249274 hasConceptScore W4387249274C203014093 @default.
• W4387249274 hasConceptScore W4387249274C2777052132 @default.
• W4387249274 hasConceptScore W4387249274C2778246068 @default.
• W4387249274 hasConceptScore W4387249274C2778311950 @default.
• W4387249274 hasConceptScore W4387249274C2778715236 @default.
• W4387249274 hasConceptScore W4387249274C2779489039 @default.
• W4387249274 hasConceptScore W4387249274C2781413609 @default.
• W4387249274 hasConceptScore W4387249274C523546767 @default.
• W4387249274 hasConceptScore W4387249274C54355233 @default.
• W4387249274 hasConceptScore W4387249274C71924100 @default.
• W4387249274 hasConceptScore W4387249274C85663871 @default.
• W4387249274 hasConceptScore W4387249274C86803240 @default.
• W4387249274 hasIssue "4" @default.
• W4387249274 hasLocation W43872492741 @default.
• W4387249274 hasOpenAccess W4387249274 @default.
• W4387249274 hasPrimaryLocation W43872492741 @default.
• W4387249274 hasRelatedWork W2047967234 @default.
• W4387249274 hasRelatedWork W2064404371 @default.
• W4387249274 hasRelatedWork W2100437968 @default.
• W4387249274 hasRelatedWork W2147499663 @default.
• W4387249274 hasRelatedWork W2412557370 @default.
• W4387249274 hasRelatedWork W2466043692 @default.
• W4387249274 hasRelatedWork W2588519941 @default.
• W4387249274 hasRelatedWork W2795726845 @default.
• W4387249274 hasRelatedWork W3004062559 @default.
• W4387249274 hasRelatedWork W4298390966 @default.
• W4387249274 hasVolume "164" @default.
• W4387249274 isParatext "false" @default.
• W4387249274 isRetracted "false" @default.
• W4387249274 workType "article" @default.