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Table 2 Main Study Findings

From: Clinical effectiveness of rapid tests for methicillin resistant Staphylococcus aureus(MRSA) in hospitalized patients: a systematic review

First author Outcome Measurement Main study findings
MRSA colonization
Hardy[25]   PCR Chromogenic agar
  PWE of MRSA positive on admission 266 (4.4%) 187 (2.8%)
  PWE of acquired MRSA 111 (1.9%) 157 (2.4%)
  Rate ratio of MRSA acquisition rate 1.49; 95% CI: 1.115-2.0003
Aldeyab[26]   PCR Chromogenic agar
  1,000 bed-days in surgical ward 20.0 22.1
  1,000 bed-days in medical/cardiology ward 11.8 20.3
  Average monthly cases of MRSA⁄100 patient-admissions in surgical ward 6.8 (range: 3.6 to 15) 7.3 (range: 5.4 to 9.3)
  Average monthly cases of MRSA⁄100 patient-admissions in medical/cardiology ward 9.0 (range: 3.3 to 12.2) 7.3 (range: 6.1 to 9.8)
Jeyaratnam[27]   PCR Chromogenic agar
  Proportion of patients who acquired MRSA 2.8% (n = 99) (95% CI: 2.26 to 3.34) 3.2% (n = 108) (95% CI: 2.6 to 3.79)
  Acquisition rate⁄1,000 patient-days 4.4 4.9
  Incidence rate ratio per 1,000 patients days at risk 0.90; 95% CI: 0.69 to 1.2
  Unadjusted odds ratio 0.88; 95% CI: 0.52 to 1.46
  Adjusted odds ratio 0.91; 95% CI: 0.61 to 1.34
MRSA infection
Pofahl[20]   Universal screening with PCR Targeted screening
  Infection rate per 100 procedures 0.09 0.23
  Infection rate per 100 procedures among patients undergoing orthopedic surgery 0.00 0.03
  Proportion of MRSA SSI 7.1% 11.6%
Robiscek[21]   Universal surveillance with PCR Baseline (i.e., no surveillance)
  MRSA infections⁄10,000 patient-days -5.0 (95% CI: -6.6 to -3.5) 8.9 (95% CI: 7.6 to 10.4)
  Change in MRSA infections from baseline to universal surveillance -69.6% (95% CI: -89.2% to -19.6%)
  Change in MRSA bacteremia from baseline to universal surveillance per 10,000 patient-days -1.1 (95% CI: -1.9 to -0.2)
Jeyaratnam[27]   PCR Chromogenic agar
  Number of patients with wound infections 21 22
  Odds ratio of wound infections 0.91; 95% CI: 0.48 to 1.7
  Number of MRSA bacteremia cases 1 2
  Odds ratio of MRSA bacteremia 0.49; 95% CI: 0.01 to 9.1
Jog[22]   12-months post MRSA screening 12-months prior to MRSA screening
  SSI rate 2.22% 3.30%
MRSA transmission rate
Jeyaratnam[27]   PCR Chromogenic agar
  MRSA transmission rate 0.33 0.36
  Incidence rate ratio 0.85; 95% CI: 0.64 to 1.12
Turnaround time from admission to results reported
   PCR Chromogenic agar
Hombach[23]   BD Gene Ohm MRSA Xpert MRSA  
  Median transport time (from collection to arrival at the laboratory) 4 hours and 25 minutes 4 hours and 25 minutes 4 hours and 25 minutes
  Median collection time (includes administration and accumulation of specimens to utilize the master mix to full capacity-for BD GeneOhm only) 6 hours and 55 minutes 1 hour and 5 minutes Directly inoculated
  Median analysis time (includes DNA extraction for BD GeneOhm MRSA and Gene Xpert) 5 hours and 40 minutes 2 hours and 20 minutes 54 hours and 30 minutes
  Median time to reporting from sampling to reporting of test results 17 hours 7 hours and 50 minutes 68 hours and 50 minutes
   PCR Chromogenic agar
   BD Gene Ohm MRSA Xpert MRSA  
Wassenberg[23] Time from start of isolation to delivery of specimen to laboratory 8.2 hours (IQR: 1.3 to 17.0) 5.0 hours (IQR: 1.0 to 16.6) 4.8 hours (IQR: 0.7 to 14.6)
  Time from arrival in the laboratory to definite result 3.6 hours (IQR: 2.2 to 6.7) 2.0 hours (IQR: 1.5 to 3.3) Not reported
Laurent[17]   PCR Chromogenic agar
  Median turnaround time 1.9 hours (IQR: 1.4 to 4.2 hours) 66.9 hours (IQR: 50.9 to 67.9 hours)
Creamer[18]   PCR Chromogenic agar
  Mean overall turnaround time 13.2 hours 46.2 hours
  Mean overall turnaround time for MRSA-positive specimens 17.1 hours (range: 2.0 to 75.8 hours) 53.9 hours (range: 26.0 to 123.8 hours)
Snyder; US; 2010[19]   PCR Chromogenic agar
  Average time to report MRSA-positive test results 17.4 hours (range: 4.12 to 31.1 hours) 28.1 hours (range: 13.9 to 49.6 hours)
  Average time to report MRSA-negative test results 14.4 hours (range: 3.12 to 33.8 hours) 51.3 hours (range: 34.32 to 65.95 hours)
Hardy [25]   PCR Chromogenic agar
  Mean turnaround time 0.9 days 2.3 days
Aldeyab[26]   PCR Chromogenic agar
  Median time interval in surgical ward 19.3 hours (IQR:13.8 to 23) 51.8 hours (IQR: 44.4 to 69)
  Median time interval in medical/cardiology ward 22.7 hours (IQR:19.8 to 23.8 hours) 42.2 hours (IQR: 40.3 to 69.6 hours)
Jeyaratnam[27]   PCR Chromogenic agar
  Median turnaround time 21.8 hours (IQR: 17.95 to 25.4) 46.4 hours (IQR: 39.1 to 66.1)
Isolation days
Wassenberg[23]   PCR Chromogenic agar
   BD Gene Ohm MRSA Xpert MRSA  
  Time from definite test result to discontinuation of isolation 0.2 hours (IQR: 0 to 0.5) 0.3 hours (0.2 to 0.5) 0.2 hours (0 to 0.5)
  Time from start of isolation to definite test result 17.8 hours (5.0 to 24.2) 14.0 hours (3.4 to 21.2) 31.9 hours (24.7 to 41.5)
  Duration of isolation 19.7 hours (6.0 to 34.6) 16.1 hours (4.0 to 24.7) 30.0 hours (24.2 to 43.0)
Jeyarathnam[27]   PCR Chromogenic agar
  Number of inappropriately isolated days 277 399
Open days
Jeyarathnam[27]   PCR Chromogenic agar
  Number of inappropriately open days 351 389
  1. IQR = Inter-quartile range; OR = Odds ratio; PWE = Patient ward episodes; SSI = Surgical site infection