• Zachary Carlson, Robyn Stoianovici, Sierra Young, Jeremiah Duby, and Erin Louie.
• Department of Clinical Pharmacy, UC Davis Medical Center, Sacramento, CA, USA. Electronic address: zacarlson@ucdavis.edu.
• Burns. 2024 Sep 2.

Introduction/ObjectiveThis retrospective cohort study aimed to determine the sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) of MRSA nasal swabs for pneumonia in burn-injured intensive care unit (ICU) patients.MethodsPatients 18 years or older admitted to the Burn ICU at a tertiary medical center from 2016 to 2021 were included if they had any burns, a pneumonia ICD-10 code, an MRSA nasal swab obtained during admission, and any respiratory cultures associated with at least five consecutive days of antibiotics.ResultsThere were 267 occurrences of pneumonia across 136 patients. MRSA nasal swabs had an overall sensitivity of 39 %, specificity of 98.7 %, PPV of 84.2 %, and NPV of 89.9 %. MRSA nasal swabs obtained less than seven days from antibiotic initiation had a specificity of 98.6 % and NPV of 98.6 %; meanwhile, swabs obtained at least seven days from antibiotic initiation had a specificity of 98.7 % and NPV of 86.4 %.ConclusionsThe high specificity and NPV indicate that negative MRSA nasal swabs obtained less than seven days from antibiotic initiation may be used to de-escalate anti-MRSA antibiotics in clinically stable burn-injured patients with suspicion of pneumonia. The decrease in NPV suggests that it may be beneficial to obtain a repeat swab periodically.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

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