Can the Xpert MRSA/SA BC assay be used as an antimicrobial stewardship tool? A prospective assay validation and descriptive impact assessment study in a South African setting

Abstract Background Positive blood cultures showing Gram positive cocci in clusters signifies either Staphylococcus aureus or the less-virulent coagulase-negative staphylococci. Rapid identification and methicillin susceptibility determination with Xpert MRSA/SA BC assay can improve management of S. bloodstream infection reduce inappropriate antibiotic use. Methods We prospectively evaluated comparison culture, on samples referred to our laboratory Western Cape, South Africa. interviewed attending clinicians upon culture result availability, assess choices estimate potential impact assay. Results Of 231 included, there was 100% concordance between (methicillin-resistant 15/15, methicillin-susceptible 42/42, staphylococci 170/170). Time final could be reduced by approximately 30 h 178 patients adequate history, optimisation antistaphylococcal therapy have occurred more than 1 day sooner 68.9% (31/45, 95% CI 53.2–81.4%). Six 11 methicillin-resistant (54.5%) received anti-MRSA cover sooner. Fifty-four days been spared, equating 0.3 (95% CI, 0.2–0.4) saved per patient, driven broad-spectrum beta-lactams (32 days, 18.0% cohort). Conclusion This has as an antimicrobial stewardship tool; costing clinical outcome should assessed.