Nasal colonization with Staphylococcus aureus is a well-referenced risk factor for postoperative surgical site infections (SSIs). Our health care system that performs >40,000 surgeries per year assessed both the diagnostic accuracy of the BD MAX StaphSR assay (MAX StaphSR), a PCR-based test that detects and differentiates S. aureus and methicillin-resistant S. aureus (MRSA), compared with our standard of care culture and the subsequent clinical impact on SSIs 1 year after implementation. In addition, residual specimens were tested by broth-enriched culture. Performance parameters for all methods were determined using latent class analysis. Direct culture was the least sensitive for S. aureus (85.1%) and MRSA (76.7%), whereas the MAX StaphSR assay and broth-enriched culture had similar sensitivities (96.7%) for MRSA. Prospective assessment using MAX StaphSR during a 1-year, postimplementation period revealed a lower rate of SSIs per 100 targeted surgeries (0.3) compared with MRSA-only screening (1.10) and no screening (2.28) (P < 0.05 for StaphSR versus MRSA-only screening and StaphSR versus no testing). MRSA and methicillin-sensitive S. aureus SSIs occurred equally (n = 14 each). The MAX StaphSR assay provided accurate detection of both S. aureus and MRSA nasal colonization in presurgical patients, allowing infection prevention measures, including presurgical prophylaxis, to be implemented in a timely and consistent manner to avoid SSIs.

金黄色葡萄球菌的鼻腔定植是术后手术部位感染 (SSI) 的一个很好参考的危险因素。我们每年进行超过 40,000 次手术的医疗保健系统评估了 BD MAX StaphSR 检测 (MAX StaphSR) 的诊断准确性，这是一种基于 PCR 的检测，可检测和区分金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌(MRSA)，与我们的护理文化标准以及实施 1 年后对 SSI 的后续临床影响进行了比较。此外，残留标本通过肉汤富集培养进行测试。使用潜在类别分析确定所有方法的性能参数。直接培养对金黄色葡萄球菌最不敏感(85.1%) 和 MRSA (76.7%)，而 MAX StaphSR 检测和富含肉汤的培养物对 MRSA 具有相似的敏感性 (96.7%)。在 1 年内使用 MAX StaphSR 进行的前瞻性评估显示，与仅进行 MRSA 筛查 (1.10) 和未筛查 (2.28) 相比，每 100 次靶向手术 (0.3) 中 SSI 的发生率较低（ StaphSR 与MRSA- P < 0.05 ）仅筛选和 StaphSR 与不测试）。MRSA 和甲氧西林敏感的金黄色葡萄球菌SSI 发生率相等（各n = 14）。MAX StaphSR 检测可准确检测两种金黄色葡萄球菌 和 MRSA 鼻腔定植术前患者，允许及时和一致地实施感染预防措施，包括术前预防，以避免 SSI。