2026 Eastern States Conference

Primary Author: Glory Petnkeu, PharmD
Additional Authors: Jessica Colmerauer, PharmD, BCIDP
Learning Objective: Audience members will be able to identify the potential antimicrobial stewardship impact of transitioning from methicillin-resistant Staphylococcus aureus culture to polymerase chain reaction nasal screening in hospitalized adults.
Background/Objective: Evaluate whether switching from MRSA culture to MRSA PCR at Howard University Hospital reduced the duration of empiric anti-MRSA therapy in hospitalized adults.
Methods: This single-center, retrospective, observational pre/post cohort study at Howard University Hospital included hospitalized adults aged 18 years or older who received empiric anti-MRSA therapy for at least 24 hours and had MRSA testing collected within 24 hours of antibiotic initiation. Patients with prior MRSA screening within 1 week, confirmed MRSA infection from another culture source, pregnancy, hospital stay under 2 days, or death within 2 days of admission will be excluded. The pre-intervention group included patients screened by MRSA culture from August 1 to November 1, 2024, and the post-intervention group included patients screened by MRSA PCR from August 1 to November 1, 2025. The primary endpoint is duration of anti-MRSA therapy; secondary endpoints are time to MRSA result, time to therapy change after result availability, rate of acute kidney injury, and length of stay. Data will be analyzed using Student’s t-test and chi-square testing.
Results: Ninety patients were included (47 culture, 43 PCR). Mean empiric anti-MRSA therapy duration decreased from 81.82 to 56.77 hours after PCR implementation, but this was not statistically significant (p = 0.2401). Time to MRSA result decreased from 26.49 to 2.32 hours (p = 0.0001). Time to therapy change also decreased from 52.88 to 31.76 hours but was not statistically significant (p = 0.1916). AKI and hospital length of stay did not differ significantly between groups.
Conclusion: Implementation of rapid MRSA PCR significantly shortened result turnaround time and may help support earlier review of empiric anti-MRSA therapy. Although reductions in therapy duration and time to therapy change were not statistically significant, the findings suggest a practical stewardship benefit and support further evaluation in larger, more targeted patient groups.
Self-Assessment Question: 
What impact can faster methicillin-resistant Staphylococcus aureus polymerase chain reaction result turnaround have on antimicrobial stewardship in hospitalized adults?
A. It can delay narrowing of antibiotic therapy until final culture results are available
B. It can support earlier discontinuation or narrowing of unnecessary broad-spectrum antibiotic therapy
C. It can require broader antibiotic coverage for a longer duration
D. It can eliminate the need for antimicrobial stewardship review