Can the Xpert MRSA/SA BC assay be used as an antimicrobial stewardship tool? A prospective assay validation and descriptive impact assessment study in a South African setting

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dc.contributor.authorReddy, Kessendrien_ZA
dc.contributor.authorWhitelaw, Andrewen_ZA
dc.date.issued2021-02-15
dc.descriptionCITATION: Reddy, K. & Whitelaw, A. 2021. Can the Xpert MRSA/SA BC assay be used as an antimicrobial stewardship tool? A prospective assay validation and descriptive impact assessment study in a South African setting. BMC Infectious Diseases, 21:177, doi:10.1186/s12879-021-05857-7.
dc.descriptionThe original publication is available at https://bmcinfectdis.biomedcentral.com
dc.description.abstractBackground: Positive blood cultures showing Gram positive cocci in clusters signifies either Staphylococcus aureus or the less-virulent coagulase-negative staphylococci. Rapid identification and methicillin susceptibility determination with the Xpert MRSA/SA BC assay can improve management of S. aureus bloodstream infection and reduce inappropriate antibiotic use. Methods: We prospectively evaluated the Xpert MRSA/SA BC assay in comparison with culture, on samples referred to our laboratory in the Western Cape, South Africa. We interviewed attending clinicians upon culture result availability, to assess antibiotic choices and estimate potential impact of the assay. Results: Of the 231 samples included, there was 100% concordance between the Xpert MRSA/SA BC assay and culture (methicillin-resistant S. aureus 15/15, methicillin-susceptible S. aureus 42/42, coagulase-negative staphylococci 170/170). Time to final result could be reduced by approximately 30 h with the assay. Of the 178 patients with adequate antibiotic history, optimisation of antistaphylococcal therapy could have occurred more than 1 day sooner in 68.9% with S. aureus bloodstream infection (31/45, 95% CI 53.2–81.4%). Six of the 11 patients with methicillin-resistant S. aureus bloodstream infection (54.5%) could have received anti-MRSA cover sooner. Fifty-four days of antibiotic therapy could have been spared, equating to 0.3 days (95% CI, 0.2–0.4) saved per patient, driven by broad-spectrum beta-lactams (32 days, in 18.0% of the cohort). Conclusion: This assay has potential as an antimicrobial stewardship tool; costing and impact on clinical outcome in patients with S. aureus bloodstream infection should be assessed.
dc.description.urihttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-05857-7
dc.description.versionPublisher's version
dc.format.extent9 pagesen_ZA
dc.identifier.citationReddy, K. & Whitelaw, A. 2021. Can the Xpert MRSA/SA BC assay be used as an antimicrobial stewardship tool? A prospective assay validation and descriptive impact assessment study in a South African setting. BMC Infectious Diseases, 21:177, doi:10.1186/s12879-021-05857-7
dc.identifier.issn1471-2334 (online)
dc.identifier.otherdoi:10.1186/s12879-021-05857-7
dc.identifier.urihttp://hdl.handle.net/10019.1/110413
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)en_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectStaphylococcus aureus
dc.subjectStaphylococcal infectionsen_ZA
dc.subjectAntimicrobialsen_ZA
dc.subjectXpert MRSA/SA BCen_ZA
dc.titleCan the Xpert MRSA/SA BC assay be used as an antimicrobial stewardship tool? A prospective assay validation and descriptive impact assessment study in a South African settingen_ZA
dc.typeArticleen_ZA
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