{'fraction_non_alphanumeric': 0.025933609958506226, 'fraction_numerical': 0.013485477178423237, 'mean_word_length': 5.7212543554006965, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Impact of Rapid mecA Polymerase Chain Reaction Rapid Diagnostic Testing for Staphylococcus aureus in a Pediatric Setting

Background Rapid mecA testing, in combination with antimicrobial stewardship intervention, has improved outcomes in adults with Staphylococcus aureus (SA) bacteremia. In pediatric patients, data comparing rapid molecular testing to conventional susceptibility testing for methicillin resistance in SA are limited, and benefits have been observed only in combination with a coordinated real-time antimicrobial stewardship response. The objective of this study was to determine the impact of rapid mecA detection on time to optimal therapy in patients at a pediatric institution without a specific antimicrobial stewardship intervention. Methods This was a retrospective cohort study at a freestanding children’s hospital including patients with a blood culture positive for SA. Outcomes before and after the implementation of rapid mecA detection via use of GeneXpert MRSA/SA BC (Cepheid, Sunnyvale, CA) were compared. The primary outcome was time to optimal therapy, which was defined as vancomycin alone for methicillin-resistant SA or nafcillin, oxacillin, or cefazolin alone for methicillin-susceptible SA. Results One hundred one patients were included, with 61 patients in the preimplementation period receiving conventional susceptibility testing only and 40 patients in the postimplementation period receiving rapid molecular mecA testing. The median (interquartile range) time (hours) to optimal therapy from culture collection was decreased from 61.5 (47.8–68.1) preimplementation to 42.5 (21.9–56.6; P = 0.003) postimplementation. Conclusions Despite lack of a protocol for response to molecular mecA test results, time to optimal therapy and vancomycin use were significantly decreased. Future studies are needed to assess the impact on infection-related outcomes and antibiotic adverse effects.