{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:33:14Z","timestamp":1791927194524,"version":"4.3.4"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"unspecified","delay-in-days":218,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X25100934_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>To investigate patterns of early methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) nasal swab use in US hospitals and the association with de-escalation of MRSA-specific antibiotics.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25100934_as2\">\n\t    <jats:title>Design:<\/jats:title>\n\t    <jats:p>Retrospective cohort study.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25100934_as3\">\n\t    <jats:title>Setting:<\/jats:title>\n\t    <jats:p>PINC-A1 Healthcare Database (2008\u20132021).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25100934_as4\">\n\t    <jats:title>Participants:<\/jats:title>\n\t    <jats:p>Adults with sepsis present on admission who received invasive mechanical ventilation by hospital day 1.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25100934_as5\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We assessed interhospital variation and time trends in early polymerase chain reaction-based MRSA nasal swab use using bivariable regression. Next, we used competing risks multivariable regression to assess the association of early (started by hospital day 2) anti-MRSA antibiotic duration with care in a high (\u226590%) versus low (&lt;10%) swab use hospital.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25100934_as6\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>We included 699,474 patients across 788 hospitals to evaluate trends in early swab use; 151,205 (21.6%) received a swab. Use of swabs varied across hospitals (median use: 6.0% [interquartile range: 0\u201337.6%; full range: 0%\u201398.0%]; median odds ratio [95% CI]: 84.7 [63.3\u2013115.6]) and overall use increased over time (3.5% in 2008 quarter 1 increasing to\u00a029.5% in 2021 quarter 4; regression coefficient [95% CI]: 0.14% [0.12%\u20130.15%]). Considering 41,599 patients (9,796 [23.6%] in 33 hospitals where \u226590% received swabs and 31,763 [76.4%] in 67 hospitals with &lt;10% use), anti-MRSA antibiotic durations were shorter in hospitals where \u226590% (vs &lt; 10%) received a swab (adjusted sub-hazard ratio for discontinuation of antibiotics [95% CI]: 1.17 [1.04\u20131.31], <jats:italic>P<\/jats:italic> = .007).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25100934_as7\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Use of early polymerase chain reaction-based MRSA nasal swabs varied across US hospitals and increased over time. Receiving care in a hospital with higher swab use was associated with shorter anti-MRSA antibiotic duration.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2025.10093","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T10:26:53Z","timestamp":1754562413000},"source":"Crossref","is-referenced-by-count":3,"title":["Methicillin-resistant <i>Staphylococcus<\/i> aureus nasal swabs: trends in use and association with outcomes"],"prefix":"10.1017","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7360-2489","authenticated-orcid":false,"given":"Hayley B.","family":"Gershengorn","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine"},{"name":"Albert Einstein College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5477-8422","authenticated-orcid":false,"given":"Hannah","family":"Wunsch","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical College"},{"name":"Sunnybrook Research Institute"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavarth","family":"Shukla","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"S2732494X25100934_ref22","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.1119"},{"key":"S2732494X25100934_ref20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2012.01402.x"},{"key":"S2732494X25100934_ref2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-0917-x"},{"key":"S2732494X25100934_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2021.12.005"},{"key":"S2732494X25100934_ref11","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02432-16"},{"key":"S2732494X25100934_ref21","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002025"},{"key":"S2732494X25100934_ref17","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202404-0813OC"},{"key":"S2732494X25100934_ref27","doi-asserted-by":"publisher","DOI":"10.1086\/491713"},{"key":"S2732494X25100934_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy024"},{"key":"S2732494X25100934_ref18","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181d61eeb"},{"key":"S2732494X25100934_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxab296"},{"key":"S2732494X25100934_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.01.066"},{"key":"S2732494X25100934_ref19","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.20f13681"},{"key":"S2732494X25100934_ref30","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae234"},{"key":"S2732494X25100934_ref23","unstructured":"23. 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