Evidence map›Paper›PMID 36319943›Full record

ArticleInfectious diseases and therapy2022

International Validation of a Methicillin-Resistant Staphylococcus aureus Risk Assessment Tool for Skin and Soft Tissue Infections.

E J Zasowski, T D Trinh, K C Claeys, M Dryden, S Shlyapnikov, M Bassetti, A Carnelutti, N Khachatryan, A Kurup, Abraham Pulido Cejudo and 3 more

Open access · goldAbstract read
In one paragraph

Article in Infectious diseases and therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 13 citations in OpenAlex.

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  5. Description ofHealthcare (Basel, Switzerland) · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 7 countries.

E J ZasowskiAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Detroit, MI, 48201, USA.
T D TrinhAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Detroit, MI, 48201, USA.
K C ClaeysAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Detroit, MI, 48201, USA.
M DrydenRoyal Hampshire County Hospital, Winchester, UK.
S ShlyapnikovI.I. Dzhanelidze Institute of Emergency Medicine, Saint Petersburg, Russia.
M BassettiDepartment of Health Sciences, Infectious Diseases Clinic, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy.
A CarneluttiDepartment of Health Sciences, Infectious Diseases Clinic, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy.
N KhachatryanDepartment of Surgery, Moscow State University of Medicine and Dentistry, Moscow, Russia.
A KurupInfectious Diseases Care, Mount Elizabeth Hospital, Singapore, Singapore.
Abraham Pulido CejudoDepartment of General Surgery, General Hospital of Mexico, Mexico City, Mexico.
L MeloHospital Dona Helena, Joinville, Brazil.
B CaoDepartment of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.
Michael J RybakAnti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Detroit, MI, 48201, USA. m.rybak@wayne.edu.ORCID http://orcid.org/0000-0002-1094-043X
Eugene Applebaum College of Pharmacy and Health Sciences · USOspedale Policlinico San Martino · ITChina-Japan Friendship Hospital · CNHospital General de México · MXMoscow State University of Medicine and Dentistry · RUMount Elizabeth Hospital · SGRoyal Hampshire County Hospital · GBSaint-Petersburg I. I. Dzhanelidze Research Institute of Emergency Medicine · RU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTo promote judicious prescribing of methicillin-resistant Staphylococcus aureus (MRSA)-active therapy for skin and soft tissue infections (SSTI), we previously developed an MRSA risk assessment tool. The objective of this study was to validate this risk assessment tool internationally.

methodsA multicenter, prospective cohort study of adults with purulent SSTI was performed at seven international sites from July 2016 to March 2018. Patient MRSA risk scores were computed as follows: MRSA infection/colonization history (2 points); previous hospitalization, previous antibiotics, chronic kidney disease, intravenous drug use, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), diabetes with obesity (1 point each). Predictive performance of MRSA surveillance percentage, MRSA risk score, and estimated MRSA probability (surveillance percentage adjusted by risk score) were quantified using the area under the receiver operating characteristic curves (aROC) and compared. Performance characteristics of different risk score thresholds across varying baseline MRSA prevalence were examined.

resultsTwo hundred three patients were included. Common SSTI were wounds (28.6%), abscess (25.1%), and cellulitis with abscess (20.7%). Patients with higher risk scores were more likely to have MRSA (P < 0.001). The MRSA risk score aROC (95%CI) [0.748 (0.678-0.819)] was significantly greater than MRSA surveillance percentage [0.646 (0.569-0.722)] (P = 0.016). Estimated MRSA probability aROC [0.781 (0.716-0.845)] was significantly greater than surveillance percentage (P < 0.001) but not the risk score (P = 0.192). The estimated negative predictive value (NPV) of an MRSA score ≥ 1 (i.e., a score of 0) was greater than 90% when MRSA prevalence was 30% or less.

conclusionThe MRSA risk score and estimated MRSA probability were significantly more predictive of MRSA compared with surveillance percentage. An MRSA risk score of zero had high predictive value and could help avoid unnecessary empiric MRSA coverage in low-acuity patients. Further study, including impact of such risk assessment tools on prescribing patterns and outcomes are required before implementation.

Indexed as

Antimicrobial stewardshipClinical decision supportMRSARisk scoreSkin and soft tissue infection

Identifiers

PMID36319943
PMCPMC9669284
OpenAlexW4307832394

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.