147 - Trends in Use of MRSA Nasal Surveillance Screens Across the United States

Publication Number: 147.6590

Camille Carre, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Elizabeth Oddo, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Stephen A. Thacker, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Daniel C. Williams, MUSC, Mount Pleasant, SC, United States; Daniel L. Brinton, Medical University of South Carolina, Charleston, SC, United States

Background: PCR MRSA nasal screening is a new tool to identify MRSA colonization in pediatric patients with infectious disease presentations. Studies suggest clinical utility in the negative predictive value of this screening for pediatric antimicrobial stewardship. However, few studies have explored its use beyond single centers.

Objective: This study aims to quantify longitudinal and regional trends in MRSA nasal screening usage across U.S. pediatric hospitals for infectious disease diagnoses.

Design/Methods: We assessed admissions at 33 study sites for children under 18 years with MRSA nasal screening conducted from January 2021 to July 2024 using the Pediatric Health Information System (PHIS). Patients with oncological and NICU diagnoses were excluded. Usage rates per 1,000 admissions were calculated, and sites were divided by geographical region. Discharge diagnoses for those tested were grouped by infectious categories and calculated as a percentage of total tests performed over four years. Infectious disease categories (respiratory, skin/soft tissue, ENT, and sepsis) were selected based on literature indicating high negative predictive value for the MRSA nasal surveillance screen.

Results: The use of MRSA nasal screening increased across all four U.S. regions from 2021 to 2024 (Fig. 1). The usage rate among nine Midwest hospitals rose by 20%. The five Northeast hospitals saw an increase of 275%. In the South, twelve hospitals experienced an 8% increase, and the seven Western hospitals showed an 18% rise. Overall, PHIS hospitals saw a 30% increase in use of the screen in three years. Categories of infectious disease-related diagnoses demonstrated an increase by 108% for respiratory infections, 77% for ENT infections, 44% for skin/soft tissue infections, and 34% for sepsis from 2021 to 2024 (Fig. 2).

Conclusion(s): The number of MRSA nasal surveillance screens performed per 1,000 admissions has increased since 2021, with trends varying significantly by location. This trend suggests a growing adoption of MRSA screening to inform clinical decisions in pediatric infectious care. Screening was most frequently performed for respiratory, ENT, skin/soft tissue infections, and sepsis. This aligns with an increasing body of literature supporting its use in these conditions. Further research will evaluate clinical decisions made based on test results across the PHIS sites and their impact on length of stay and duration of MRSA-targeted antibiotic treatment.

Fig. 1: MRSA screens per 1,000 admissions by geographical area
Each line represents a PHIS hospital with each hospital categorized based on U.S. census geographical location.

Fig. 2: Proportion of admissions with MRSA screening performed grouped by ID diagnosis categories


Fig. 1: MRSA screens per 1,000 admissions by geographical area
Each line represents a PHIS hospital with each hospital categorized based on U.S. census geographical location.

Fig. 2: Proportion of admissions with MRSA screening performed grouped by ID diagnosis categories