ArticleOpen access emergency medicine : OAEM2013
Feasibility of rapid polymerase chain reaction for detection of methicillin-resistant Staphylococcus aureus colonization among emergency department patients with abscesses.
Article in Open access emergency medicine : OAEM, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Antimicrobial Stewardship in the Emergency Department.Emergency medicine clinics of North America · 2018Review
- Effectiveness of Outpatient Antibiotics After Surgical Drainage of Abscesses in Reducing Treatment Failure.The Journal of emergency medicine · 2018Observational
- Update on management of skin and soft tissue infections in the emergency department.Current infectious disease reports · 2014Article
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Authors and funding
7 authors.
Funding
Abstract
purposeIn the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA), clinicians face a difficult challenge when selecting antibiotics to treat abscesses. The lack of rapid diagnostics capable of identifying the causative organism often results in suboptimal antibiotic stewardship practices. Although not fully elucidated, the association between MRSA colonization and subsequent infection represents an opportunity to enhance antibiotic selectivity. Our primary objective was to examine the feasibility of utilizing a rapid polymerase chain reaction (PCR) system (Cepheid's GeneXpert(®)) to detect MRSA colonization prior to patient discharge in the emergency department (ED).
methodsThis feasibility study was conducted at a tertiary care, urban, academic ED. Patients presenting with a chief complaint related to a potential abscess during daytime hours over an 18-week period were screened for eligibility. Subjects were enrolled into either the PCR swab protocol group (two-thirds) or traditional care group (one-third). PCR swabs were obtained from known MRSA carriage sites (nasal, pharyngeal) and the superficial aspect of the wound.
resultsThe two groups were similar in terms of demographics, abscess location, and MRSA history. The PCR results were available prior to patient discharge in 100% of cases. The turnaround times in minutes for the PCR swabs were as follows: nasal 73 ± 7, pharyngeal 82 ± 14, and superficial wound 79 ± 17. No significant difference in length of stay was observed between the two groups. The observed ideal antibiotic selection rates improved by 45% in the PCR group, but this trend was not significant (P = 0.08).
conclusionWhen collected in triage, PCR swabs demonstrated turnaround times that were effective for use in the ED setting. Utilizing a rapid PCR MRSA colonization detection assay for ED patients with abscesses did not adversely impact the length of stay. Real-time determination of MRSA colonization may represent an opportunity to improve antibiotic selectivity in the treatment of abscesses.
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