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Brief Report

Ventilator-Associated Pneumonia Due to MRSA vs. MSSA: What Should Guide Empiric Therapy?

1
Division of Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
2
Department of Biosciences, University of Milan, 20126 Milan, Italy
3
Anesthesiology and Resuscitation Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
4
Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
5
Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
6
Department of Medical, Surgical, Diagnostic and Paediatric Science, University of Pavia, 27100 Pavia, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editors: Masafumi Seki, Daniel Echeverría-Esnal, Santíago Grau and Silvia Gómez-Zorrilla
Antibiotics 2022, 11(7), 851; https://doi.org/10.3390/antibiotics11070851
Received: 30 April 2022 / Revised: 20 June 2022 / Accepted: 20 June 2022 / Published: 24 June 2022
(This article belongs to the Special Issue Antibiotic Use and Stewardship in Hospital)
The guidelines on ventilator-associated pneumonia (VAP) recommend an empiric therapy against methicillin-resistant Staphylococcus aureus (MRSA) according to its prevalence rate. Considering the MRSA and MSSA VAP prevalence over the last 9 years in our tertiary care hospital, we assessed the clinical value of the MRSA nasal-swab screening in either predicting or ruling out MRSA VAP. We extracted the data of 1461 patients with positive bronchoalveolar lavage (BAL). Regarding the MRSA nasal-swab screening, 170 patients were positive for MRSA or MSSA. Overall, MRSA had a high prevalence in our ICU. Despite the COVID-19 pandemic, there was a significant downward trend in MRSA prevalence, while MSSA remained steady over time. Having VAP due to MRSA did not have any impact on LOS and mortality. Finally, the MRSA nasal-swab testing demonstrated a very high negative predictive value for MRSA VAP. Our results suggested the potential value of a patient-centered approach to improve antibiotic stewardship. View Full-Text
Keywords: ventilator-associated pneumonia; methicillin-resistant Staphylococcus aureus; intensive care unit; negative predictive value ventilator-associated pneumonia; methicillin-resistant Staphylococcus aureus; intensive care unit; negative predictive value
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MDPI and ACS Style

Colaneri, M.; Di Carlo, D.; Amatu, A.; Marvulli, L.N.; Corbella, M.; Petazzoni, G.; Cambieri, P.; Muzzi, A.; Bandi, C.; Di Matteo, A.; Sacchi, P.; Mojoli, F.; Bruno, R. Ventilator-Associated Pneumonia Due to MRSA vs. MSSA: What Should Guide Empiric Therapy? Antibiotics 2022, 11, 851. https://doi.org/10.3390/antibiotics11070851

AMA Style

Colaneri M, Di Carlo D, Amatu A, Marvulli LN, Corbella M, Petazzoni G, Cambieri P, Muzzi A, Bandi C, Di Matteo A, Sacchi P, Mojoli F, Bruno R. Ventilator-Associated Pneumonia Due to MRSA vs. MSSA: What Should Guide Empiric Therapy? Antibiotics. 2022; 11(7):851. https://doi.org/10.3390/antibiotics11070851

Chicago/Turabian Style

Colaneri, Marta, Domenico Di Carlo, Alessandro Amatu, Lea Nadia Marvulli, Marta Corbella, Greta Petazzoni, Patrizia Cambieri, Alba Muzzi, Claudio Bandi, Angela Di Matteo, Paolo Sacchi, Francesco Mojoli, and Raffaele Bruno. 2022. "Ventilator-Associated Pneumonia Due to MRSA vs. MSSA: What Should Guide Empiric Therapy?" Antibiotics 11, no. 7: 851. https://doi.org/10.3390/antibiotics11070851

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