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Redefining MRSA Screening Protocols: A New Approach from Belgian Geriatric Units

Practicing universal screening for Methicillin-resistant Staphylococcus aureus (MRSA) carries many uncertainties in terms of cost-effectiveness and widespread consensus, especially when it involves high-risk units. This ambiguity has led to an investigation aimed at identifying the prevalence of MRSA in geriatric care units and highlighting the reasons behind this colonisation upon admission. A meticulous retrospective case-control study (1:1) was carried out within six Belgian hospitals’ geriatric care unit, encompassing data gathered from January 2021 to December 2022.

Patients with a positive MRSA screening result within 48 hours of admission were identified as cases, while controls represented patients with a negative screening result. In total, the study included 556 patients, evenly distributed among the two groups. The noted prevalence per 100 admissions for the complete sample was 2.3, captured within a 95%CI of 2.2-2.6. Multivariate analysis showed that a history of MRSA, origin from a nursing home, and presence of chronic skin lesions were significant factors associated with MRSA carriage at the point of admission.

Predictive modeling, utilizing these three determinant factors, resulted in a remarkable area under the ROC curve of 0.73 (0.71-0.77). Such a model would potentially facilitate screening carried out in only 55.4% of cases (51.2%-59.6%). Applying these criteria in geriatric care units could lead to a noteworthy reduction in the number of patients needed to be screened for MRSA. This strategy yet maintains a commendable balance of sensitivity and specificity. Université Libre de Bruxelles, Belgium and the Réseau Hospitalier Universitaire Cœur de Wallonie, Belgium were among the institutions contributing to this breakthrough research. The content presented is based on findings published by Elsevier Ltd in 2024.

Source: https://www.physiciansweekly.com/prevalence-and-factors-associated-with-methicillin-resistant-staphylococcus-aureus-mrsa-colonisation-on-admission-to-geriatric-care-units-impact-on-screening-practices/

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