Diagnostic accuracy of pre-surgical Staphylococcus aureus PCR assay compared to culture and post-PCR implementation surgical site infection rates.
J Mol Diagn. 2020 May 23;:
Authors: Tansarli GS, LeBlanc L, Auld DB, Chapin KC
Nasal colonization with S. aureus is a well referenced risk factor for post-operative surgical site infections (SSIs). Our healthcare system that performs >40,000 surgeries per year assessed both the diagnostic accuracy of the BD MAX StaphSR (MAX StaphSR) assay, a PCR-based test that detects and differentiates Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA), compared to our standard of care culture and the subsequent clinical impact on SSIs one year after implementation. Additionally, residual specimens were tested by broth-enriched culture. Performance parameters for all methods were determined using latent class analysis. Direct culture was the least sensitive for S. aureus (85.1%) and MRSA (76.7%), while the MAX StaphSR assay and broth-enriched culture had similar sensitivities (96.7%) for MRSA. Prospective assessment using MAX StaphSR during a one-year, post-implementation period revealed a lower rate of surgical site infections (SSI) per 100 targeted surgeries (0.3) compared to MRSA-only screening (MRSA-SC;1.10) and no screening (2.28) (p<0.05 for StaphSR vs. MRSA-SC and StaphSR vs. no testing). MRSA and MSSA SSIs occurred equally (n=14 each). The MAX StaphSR assay provided accurate detection of both S. aureus and MRSA nasal colonization in pre-surgical patients allowing infection prevention measures, including pre-surgical prophylaxis to be implemented in a timely and consistent manner to avoid SSIs.
PMID: 32454221 [PubMed - as supplied by publisher]