To Evaluate the Impact of MRSA Nasal Screen Implementation.

Routine blood and sputum cultures are often obtained inpatient for critically ill pneumonia patients. These tests, however, tend to have a high yield of false positives, leading to an increase in the use of broad spectrum antibiotics, specifically vancomycin. The Methicillin-resistant Staphylococcus aureus(MRSA) nasal screen is an antimicrobial stewardship tool that can be used to guide the treatment of community-acquired, hospital-acquired and ventilator-associated pneumonia. Due to its strong negative predictive value; a negative result can accurately indicate the absence of an MRSA infection in 96% of cases. Long-term treatment with vancomycin in patients with pneumonia is nephrotoxic and not always warranted. The implementation of an MRSA nasal screen in all patients with pneumonia treated with vancomycin has the potential to reduce vancomycin duration of therapy, decrease the risk of adverse effects and decrease the cost associated with vancomycin use.

Inclusion criteria

• Age > 18 years
• Diagnosis of pneumonia
• Admission inpatient to Methodist Richardson Medical Center
• Treatment with vancomycin empirically

Exclusion criteria

• Age ≤ 18 years
• Patients with other confirmed gram positive infections