Correlation of MRSA polymerase chain reaction (PCR) nasal swab in ventilator-associated pneumonia, lung abscess, and empyema.

Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen empirically covered in pulmonary infections. Limited studies evaluate the relationship between the MRSA PCR nasal swab assays and clinically diagnosed ventilator-associated pneumonia (VAP), lung abscess, and empyema. This retrospective, single-center study included 161 patients, which aimed to validate the clinical utility of MRSA PCR nasal swabs in VAP, lung abscess, and empyema through sensitivity, specificity, positive predictive value (PPV), and negative predicative value (NPV) analysis. VAP had a 100% sensitivity, 89% specificity, 67% PPV, and 100% NPV.  Lung abscess had a 0% sensitivity, 90% specificity, 0% PPV, 90% NPV. Empyema had a 80% sensitivity, 84% specificity, 42% PPV, and 97% NPV. The study results demonstrate that the MRSA PCR nasal swab assay has the potential to be a vital tool in de-escalating antimicrobial therapy in VAP, lung abscess, and empyema.

Impact of MRSA polymerase chain reaction (PCR) wound swabs on antibiotic de-escalation in skin and soft tissue infections.

Methicillin-resistant strains of S. aureus (MRSA) polymerase chain reaction (PCR) testing is a laboratory test that allows for rapid detection of MRSA and is available to use in skin infections via wound swab. There are limited data demonstrating the utility of MRSA PCR wound swabs on clinical outcomes in skin and soft tissue infections. This retrospective, single-center study included 652 patients to determine if the use of a MRSA PCR wound swab in skin infections results in a more rapid de-escalation in antibiotics. Patients with a MRSA PCR negative wound swab demonstrated a 1.0 (-1.5 to -0.53) day reduction of anti-MRSA antibiotic usage compared to those in the control group who did not have a MRSA PCR available (wound culture data only) (P < 0.001, unadjusted). The results of this study demonstrate that MRSA PCR wound swab assays have the potential to play a significant role in antibiotic de-escalation in the setting of skin and soft tissue infections.

Correlation of MRSA polymerase chain reaction (PCR) wound swab testing and wound cultures in skin and soft tissue infections.

Methicillin-resistant Staphylococcus aureus is a considerable pathogen in the setting of skin and soft tissue infections (SSTIs). MRSA PCR swab testing is widely used in the setting of respiratory tract infections, however little data exists relating to the use of MRSA PCR swab testing in SSTIs. Three thousand, nine hundred and ninety-five patients were included in this retrospective study that aimed to validate the clinical correlation of MRSA PCR wound swab testing in SSTIs through sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) analysis. From this review, MRSA PCR wound swabs were found to have a sensitivity of 97.6% (97.5-98.5), a specificity of 94.9% (94.3-95.7), a PPV of 92.3% (91.4-93.2), and a NPV of 98.4% (98.0-98.8). The study results demonstrate that the MRSA SSTI PCR assays have a high NPV and the potential to be a vital tool in de-escalating antimicrobial therapy associated with SSTIs.

Interdisciplinary communication to efficiently develop integrated pharmacotherapeutic sessions.

INTRODUCTION: Integration of clinical, biomedical, social, administrative, and pharmaceutical sciences in a pharmacotherapeutics course is beneficial to student education. Unfortunately, the perceived increase in time, commitment, and workload required to produce integrated material often serves as a barrier to high level academic integration. This commentary discusses how interdisciplinary faculty communication started at the beginning of content development, using an initial brief planning session and ongoing unscheduled flexible methods, can efficiently produce integrated material without substantially increasing faculty workload compared to independently produced integrated course material. COMMENTARY: Content development can be streamlined during a short initial meeting to consider the relevant disciplines (e.g., pharmacology, medicinal chemistry, clinical sciences) for a topic and to collaboratively develop corresponding content outlines. To produce fully integrated material, collaborators should develop content using a cloud-based file sharing system and communicate using asynchronous, electronic means to ask questions and provide suggestions to collaborators. IMPLICATIONS: Interdisciplinary communication is the foundation of integrated pharmacotherapeutic sessions, but supplemental meetings in addition to already required faculty meetings are both challenging to schedule and time consuming. With proper planning and the deliberate use of both continuous file sharing and asynchronous electronic communication, educators can produce parallel content emphasizing key concepts across disciplines without substantially increasing faculty workload.