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Title of Journal: Intensive Care Med

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Abbravation: Intensive Care Medicine

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Springer-Verlag

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DOI

10.1016/j.apsusc.2006.04.029

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1432-1238

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Throat and rectal swabs may have an important role

Authors: Rahul Batra Alice C Eziefula Duncan Wyncoll Jonathan Edgeworth
Publish Date: 2008/05/24
Volume: 34, Issue: 9, Pages: 1703-1706
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Abstract

Methicillinresistant Staphylococcus aureus MRSA is a major problem in intensive care units ICU International guidelines recommend screening patients for MRSA on admission although consensus on sites required for optimum detection has not been reached Our aim was to determine whether throat and rectal swabs identified a significant number of additional MRSAcolonised patients not captured by swabbing at keratinized skin carriage sites anterior nares perineum and axillaeSwabs from carriage sites anterior nares perineum axillae throat and rectum wounds and clinical samples taken within 48 h of ICU admission were analysed to identify patients admitted with MRSA A complete set of carriage swabs were received from 1470 patients 105 7 patients were admitted with MRSA of which 63 60 were detected by a pooled keratinized skin swab anterior nares perineum axillae A further 36 34 patients were detected only by throat or rectal swabs Indeed throat and rectal swabs combined had a higher sensitivity than pooled keratinised skin swabs 76 vs 60 P = 00247 Swabs from all carriage sites together detected 95 100 of MRSA positive patients with five patients being positive at wound sites only

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