Rapid identification of hospitalized patients at high risk for MRSA carriage

Area of Science:

• Medical Microbiology
• Infectious Disease Epidemiology
• Health Informatics

Background:

• Asymptomatic carriers of methicillin-resistant Staphylococcus aureus (MRSA) are significant reservoirs for hospital-acquired infections.
• Healthcare professionals often lack awareness of high-risk patients carrying MRSA during hospitalization.
• Effective identification strategies are crucial to prevent MRSA transmission in healthcare settings.

Purpose of the Study:

• To develop and evaluate an enterprise-wide electronic surveillance system for identifying patients at high risk of MRSA carriage.
• To assess the system's ability to detect MRSA carriage at hospital admission and during the patient's stay.
• To determine the system's reliability and timeliness in alerting medical personnel.

Main Methods:

• Development and implementation of an enterprise-wide electronic surveillance system.
• Utilized polymerase chain reaction (PCR) for MRSA detection in nasal swabs from high-risk patients.
• Compared MRSA carriage rates between high-risk and low-risk patient groups during a two-month study.

Main Results:

• The electronic surveillance system identified 20.3% of high-risk patients as MRSA carriers, significantly higher than the 4.1% in low-risk patients (p < 0.001).
• The average time from admission to PCR result availability was 19.2 hours.
• Computer alerts generated by the system were found to be reliable and timely.

Conclusions:

• The electronic surveillance system is a reliable and timely tool for identifying high-risk MRSA patients at hospital admission.
• The system has the potential to replace universal MRSA testing, optimizing resource allocation.
• Previous MRSA colonization is a strong predictor, but incorporating additional risk factors can enhance predictive sensitivity.