Utility of methicillin‐resistant <i>Staphylococcus aureus</i> (MRSA) nasal screening in patients with acute myeloid leukemia (AML)

Background Current literature has demonstrated the utility of MRSA nasal screen as a de-escalation tool to decrease unnecessary anti-MRSA antibiotic therapy. However, data on applicability this test in patients with hematologic malignancy is lacking. Methods This single-center, retrospective cohort study acute myeloid leukemia (AML) or without history hematopoietic cell transplant (HCT), pneumonia and screening respiratory cultures obtained. The primary outcome was determine negative predictive value (NPV) for pneumonia. Secondary outcomes included sensitivity, specificity, positive (PPV) prevalence Results Of 98 AML pneumonia, 4.1% confirmed observed 4 patient cases. In 3 had screens while 1 false result, possibly due long lag time (21 days) between diagnosis. Overall, 75% sensitivity 100% PPV NPV 98.9%. Conclusions Given low prevalence, empiric use therapy those HCT may not be warranted clinically stable patients. For whom antibiotics are initiated, utilized de-escalate HCT.