{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T05:26:42Z","timestamp":1776058002967,"version":"3.50.1"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"23","license":[{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Colonization of methicillin-resistant Staphylococcus aureus (MRSA) can be detected via nasal screens. Evidence indicates that negative MRSA nasal screens may be used to de-escalate anti-MRSA antibiotics in pulmonary infections. In the ICU, universal decolonization with intranasal mupirocin is implemented to reduce MRSA infection risk. This study aimed to determine whether mupirocin administration affects the reliability of MRSA PCR nasal screens.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective study divided subjects based on timing of intranasal mupirocin administration\u2014before and after MRSA screen. Subjects with confirmed pulmonary infection that received vancomycin, blood\/respiratory cultures, and had MRSA PCR screen collected were included. Subjects with concurrent infection requiring vancomycin or MRSA infection in prior 30 days were excluded. Primary outcome of this non-inferiority study was the negative predictive value (NPV) of the screen. Secondary outcomes included the positive predictive value (PPV), sensitivity, and specificity of the screen and duration of vancomycin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ultimately, 125 subjects were included in each group. The NPV in the group receiving mupirocin before screen was 95.2%, whereas the NPV in the group receiving mupirocin after screen was 99%. The difference between groups was -3.8% (90% CI -7.8%-0.2%; p=0.31), which failed to meet non-inferiority criteria. The secondary outcomes of PPV, sensitivity and specificity of the screen were similar in both groups. The duration of vancomycin was significantly longer in subjects receiving mupirocin before screen (3 days vs. 2 days; p&amp;lt;0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Intranasal mupirocin prior to the screen may reduce NPV in pulmonary infections. Approach de-escalation of vancomycin based on screen results with caution.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxaa284","type":"journal-article","created":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T04:54:26Z","timestamp":1600750466000},"page":"1965-1972","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of the reliability of MRSA screens in patients undergoing universal decolonization"],"prefix":"10.1093","volume":"77","author":[{"given":"Amna","family":"Chaudhry","sequence":"first","affiliation":[{"name":"Ascension St. Vincent\u2019s HealthCare, Jacksonville, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Allen","sequence":"additional","affiliation":[{"name":"Ascension St. Vincent\u2019s HealthCare, Jacksonville, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meagan","family":"Paylor","sequence":"additional","affiliation":[{"name":"Ascension St. Vincent\u2019s HealthCare, Jacksonville, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Hayes","sequence":"additional","affiliation":[{"name":"Ascension St. Vincent\u2019s HealthCare, Jacksonville, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,9,22]]},"reference":[{"issue":"6","key":"2020111610005709600_CIT0001","doi-asserted-by":"crossref","first-page":"3854","DOI":"10.1378\/chest.128.6.3854","article-title":"Epidemiology and outcomes of health-care-associated pneumonia: results from a large US database of culture-positive pneumonia","volume":"128","author":"Kollef","year":"2005","journal-title":"Chest"},{"key":"2020111610005709600_CIT0002","first-page":"2237","article-title":"Staphylococcus aureus (including staphylococcal toxic shock syndrome).","volume-title":"Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases","author":"Que","edition":"8th ed"},{"key":"2020111610005709600_CIT0003","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1093\/cid\/ciw504","article-title":"Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society","volume":"63","author":"Kalil","year":"2016","journal-title":"Clin Infect Dis"},{"issue":"7","key":"2020111610005709600_CIT0004","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and treatment of adults with community-acquired pneumonia. 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