Role of healthcare workers in outbreaks of methicillin-resistant Staphylococcus aureus: a 10-year evaluation from a Dutch university hospital
| Autor: | Christina M. J. E. Vandenbroucke-Grauls, Ada C. M. Gigengack-Baars, Hetty E. M. Blok, Ellen M. Mascini, A. J. L. Weersink, Jan Verhoef, Titia E. M. Kamp-Hopmans, Annet Troelstra |
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| Přispěvatelé: | Medical Microbiology and Infection Prevention |
| Rok vydání: | 2003 |
| Předmět: |
Microbiology (medical)
Adult Pediatrics medicine.medical_specialty Staphylococcus aureus Isolation (health care) Epidemiology health care facilities manpower and services Attack rate education Mupirocin medicine.disease_cause Personnel Management Disease Outbreaks Hospitals University chemistry.chemical_compound Risk Factors medicine Prevalence Humans Mass Screening Mass screening Antibacterial agent Netherlands Cross Infection Transmission (medicine) business.industry virus diseases biochemical phenomena metabolism and nutrition Staphylococcal Infections bacterial infections and mycoses Methicillin-resistant Staphylococcus aureus Personnel Hospital Infectious Diseases Carriage chemistry Emergency medicine Carrier State Workforce Methicillin Resistance business |
| Zdroj: | Infection control and hospital epidemiology, 24(9), 679-685. Cambridge University Press |
| ISSN: | 0899-823X 0195-9417 |
| Popis: | Background and Objective:The benefit of screening healthcare workers (HCWs) at risk for methicillin-resistantStaphylococcus aureus(MRSA) carriage and furloughing MRSA-positive HCWs to prevent spread to patients is controversial. We evaluated our MRSA program for HCWs between 1992 and 2002.Setting:A university medical center in the Netherlands, where methicillin resistance has been kept below 0.5% of all nosocomial S.aureusinfections using active surveillance cultures and isolation of colonized patients.Design:HCWs caring for MRSA-positive patients or patients in foreign hospitals were screened for MRSA. MRSA-positive HCWs had additional cultures, temporary exclusion from patient-related work, assessment of risk factors for persisting carriage, decolonization therapy with mupirocin intranasally and chlorhexidine baths for skin and hair, and follow-up cultures.Results:Fifty-nine HCWs were colonized with MRSA. Seven of 840 screened employees contracted MRSA in foreign hospitals; 36 acquired MRSA after contact with MRSA-positive patients despite isolation precautions (attack rate per outbreak varied from less than 1% to 15%). Our hospital experienced 17 MRSA outbreaks, including 13 episodes in which HCWs were involved. HCWs were index cases of at least 4 outbreaks. In 8 outbreaks, HCWs acquired MRSA after caring for MRSA-positive patients despite isolation precautions.Conclusion:Postexposure screening of HCWs allowed early detection of MRSA carriage and prevention of subsequent transmission to patients. Where the MRSA prevalence is higher, the role of HCWs may be greater. In such settings, an adapted version of our program could help prevent dissemination. |
| Databáze: | OpenAIRE |
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