Research Note: Predicting MRSA Colonization of the Hospitalized Patient on Admission

The primary aim of this brief and exploratory study was to examine the ability of two Infection Control Practitioners in a medium size community hospital to effectively predict the MRSA colonization status of patients on admission compared to a standard MRSA screen in real time using only their clinical judgment and review of selected hospital documents. Sensitivity and specificity results for the clinical prediction of MRSA were 0.88 (95% CI, 0.64-0.96) and 0.79 (95% CI, 0.70-0.85), respectively. The positive predictive value and negative predictive value were 0.39 (95% CI, 0.25-0.55) and 0.97 (95% CI, 0.91-0.99), respectively. The overall accuracy of the ICPs ruling in or ruling out MRSA nares colonization was 80%. These results suggest that ICPs were able to rule out MRSA colonization with a high degree of confidence and accuracy. However, confirmation of MRSA colonization based on clinical judgment was less sensitive.