KY-MRSA: a comprehensive review of methicillin-resistant Staphylococcus aureus polymerase chain reaction nasal screening practices across nine institutions in Kentucky

TL;DR

This paper reviews how nine Kentucky hospitals use nasal PCR tests to detect MRSA, highlighting common practices and differences.

Contribution

The study provides the first statewide overview of nasal MRSA PCR screening practices in Kentucky.

Findings

Most institutions with PCR testing had established protocols for nasal MRSA screening.

All institutions recommended PCR testing for pneumonia, but only three used it for non-pneumonia cases.

No institution allowed pharmacists to stop MRSA antibiotics based on PCR results.

Abstract

To describe the screening practice of nasal methicillin-resistant Staphylococcus aureus (MRSA) polymerase chain reaction (PCR) among nine health organizations in Kentucky.

The Kentucky Antimicrobial Stewardship Innovation Consortium (KASIC) invited its Advisory Board members to share their nasal MRSA PCR protocols and guidelines. The documents were examined to highlight institutional similarities and differences.

Nine health systems, including both community hospitals and academic medical centers, responded to the KASIC request. Most systems with nasal MRSA PCR testing capacity had established protocols or guidelines to support its appropriate use. All institutions recommended nasal MRSA PCR for pneumonia indications while three organizations also used it for non-pneumonia indications. None of these institutions permitted pharmacists to discontinue anti-MRSA antibiotics per protocol.

This study provides the first statewide overview of nasal MRSA PCR screening practices, offering stewardship programs a framework to customize their own protocols and guidelines.

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