Tsang S T J, McHugh M P, Guerendiain D, Gwynne P J, Boyd J, Simpson A H R W, Walsh T S, Laurenson I F, Templeton K E
Department of Orthopaedic Surgery, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SB, UK and School of Biological Sciences, University of Edinburgh, King's Buildings, Mayfield Road, Edinburgh EH9 3JR, UK
Department of Medical Microbiology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.
Bone Joint Res. 2018 Jan;7(1):79-84. doi: 10.1302/2046-3758.71.BJR-2017-0175.R1.
Nasal carriers of ( and ) have an increased risk for healthcare-associated infections. There are currently limited national screening policies for the detection of despite the World Health Organization's recommendations. This study aimed to evaluate the diagnostic performance of molecular and culture techniques in screening, determine the cause of any discrepancy between the diagnostic techniques, and model the potential effect of different diagnostic techniques on detection in orthopaedic patients.
Paired nasal swabs for polymerase chain reaction (PCR) assay and culture of were collected from a study population of 273 orthopaedic outpatients due to undergo joint arthroplasty surgery.
The prevalence of nasal colonization was found to be between 22.4% to 35.6%. The current standard direct culturing methods for detecting significantly underestimated the prevalence (p = 0.005), failing to identify its presence in approximately one-third of patients undergoing joint arthroplasty surgery.
Modelling these results to national surveillance data, it was estimated that approximately 5000 to 8000 surgical site infections could be prevented, and approximately $140 million to $950 million (approximately £110 million to £760 million) saved in treatment costs annually in the United States and United Kingdom combined, by using alternative diagnostic methods to direct culture in preoperative screening and eradication programmes.: S. T. J. Tsang, M. P. McHugh, D. Guerendiain, P. J. Gwynne, J. Boyd, A. H. R. W. Simpson, T. S. Walsh, I. F. Laurenson, K. E. Templeton. Underestimation of Staphylococcus aureus (MRSA and MSSA) carriage associated with standard culturing techniques: One third of carriers missed. 2018;7:79-84. DOI: 10.1302/2046-3758.71.BJR-2017-0175.R1.
耐甲氧西林金黄色葡萄球菌（MRSA）和甲氧西林敏感金黄色葡萄球菌（MSSA）的鼻腔携带者发生医疗保健相关感染的风险增加。尽管世界卫生组织有相关建议，但目前国内针对检测MRSA的筛查政策有限。本研究旨在评估分子和培养技术在MRSA筛查中的诊断性能，确定诊断技术之间出现差异的原因，并模拟不同诊断技术对骨科患者中MRSA检测的潜在影响。
从273名因计划接受关节置换手术的骨科门诊患者研究人群中采集配对的鼻拭子，用于聚合酶链反应（PCR）检测和MRSA培养。
发现MRSA鼻腔定植率在22.4%至35.6%之间。当前用于检测MRSA的标准直接培养方法显著低估了定植率（p = 0.005），未能在约三分之一接受关节置换手术的患者中识别出其存在。
将这些结果应用于国家监测数据模型，估计通过在术前MRSA筛查和根除计划中使用替代诊断方法而非直接培养，在美国和英国每年可预防约5000至8000例MRSA手术部位感染，并节省约1.4亿至9.5亿美元（约1.1亿至7.6亿英镑）的治疗费用。作者：S. T. J. 曾、M. P. 麦克休、D. 格雷伦迪亚因、P. J. 格温、J. 博伊德、A. H. R. W. 辛普森、T. S. 沃尔什、I. F. 劳伦森、K. E. 邓普顿。与标准培养技术相关的金黄色葡萄球菌（MRSA和MSSA）定植低估：三分之一的携带者被漏检。《骨与关节研究》2018年；7卷：79 - 84页。DOI: 10.1302/2046 - 3758.71.BJR - 2017 - 0175.R1 。
