Predictive Value of Mrsa Nasal Swab in Patients with Covid-19 and Secondary Bacterial Pneumonia

INTRODUCTION: Secondary bacterial pneumonia in patients with COVID-19 is a severe complication. It has been noted that the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) positive respiratory cultures in patients with COVID-19 is approximately 6%. However, the true prevalence of bacterial co-infection in these patients is unknown. However, we do not know if infection with the SARS-COV-2 virus or the development of COVID-19 impacts the performance of the MRSA nasal swab screening test. Thus, we conducted a retrospective cohort study evaluating the predictive value of MRSA screening swabs in patients with COVID-19 and secondary bacterial pneumonia. METHOD(S): This was an IRB-approved, retrospective cohort study of patients who had nasopharyngeal specimens positive for SARS-COV-2 virus, screening MRSA nasal swabs performed, and bacterial cultures collected. Patients were diagnosed with pneumonia based on a standardized definition. The primary objective of this study was to determine the sensitivity, specificity, positive predictive value, and negative predictive value of a positive MRSA nasal swab and MRSA pneumonia in patients who are also positive for the SARS-COV-2 virus. Secondary outcomes included hospital length of stay, in-hospital mortality, and antibiotic therapies. RESULT(S): A total of 293 patients were included in the final analysis and 662 microbiological samples were evaluated in this study. The specificity (91.8% [95% CI 88.6% to 95%]) and negative predictive values (NPV 97.4% [95% CI 95.4% - 99.3%]) of MRSA nasal swabs were high. However, the sensitivity (46.2%;95% CI 19.1% to 73.3%) and positive predictive value (PPV 20.7%;95% CI 59.5 - 35.4%) were low. Those patients with a negative MRSA nasal swab had a median length of stay of 14 days (IQR 6 days to 26 days) and those with a positive nasal swab had a median length of stay of 20 days (IQR 12 days to 28 days) (p=0.096). There was no difference in in-hospital mortality. CONCLUSION(S): In general, screening MRSA swabs in patients with COIVD-19 had a high NPV and low positive PPV. Thus, the performance of screening MRSA swabs in patients with COIVD-19 and secondary bacterial pneumonia was similar to those patients without COVID-19.

Gender inequalities during COVID-19

The onset of the global COVID-19 pandemic put a halt to progress toward gender equality and, instead, exacerbated existing gender inequalities across domains—from gendered divisions of labour to economic stability. In this paper we document some of the most glaring gender inequalities that have arisen in the COVID-19 pandemic and discuss how social psychological theories and research—including work on gender stereotypes and roles, responses to threat, precarious masculinity, perceptions of risk, and backlash—can help to explain the roots of these inequalities. In doing so, we use a broad definition of gender and consider relevant intersections of identity. Finally, we present three key considerations for research on gender inequalities moving forward. Namely, the need for social psychologists to (a) challenge binary conceptualizations of gender, (b) broaden the focus of research on gender inequalities, and (c) adopt an intersectional lens to address systemic inequalities in the wake of COVID-19. © The Author(s) 2021.