The positively-tested participant did not work in the ambulant sector outside of the heart center and had neither contact to pets nor to farm animals. Spa types associated with this strain are t, t, t, t, t The isolate was mecA positive and PVL negative. The sample tested positive for the leukotoxin gamma-hemolysin. According to hygiene regulations at the heart center, workers with infectious diseases are prohibited from working with patients if a transmission of disease cannot be ruled out.
On admission to the acute care hospital, patients are screened for MRSA and 4 MRGN if they have a history of MRSA, have chronic wounds, are on dialysis, or were transferred from other hospitals and rehabilitation centers. Patients with MRSA are isolated in single rooms. Successful decolonization of a patient is confirmed by three negative nose smears and one negative throat smear at least 3 days after antiseptic treatment. Furthermore, well qualified and sufficient hygiene personnel are essential for preventing nosocomial infections.
In Saxony, the number and qualification of hygienists in health facilities was legally determined in [ 26 ]. Thus, the low observed prevalence of MRSA might have resulted from sufficient hygiene staff education and compliance to hygiene measures [ 27 ]. The participant had close contact to patients with MRSA within the last 4 weeks but reported wearing protective clothing at all times. Thus, although the sample size is too low to make general assumptions about risk factors for MRSA carriage, our results fit to the body of evidence for potential risk factors [ 28 , 29 ].
The isolated strain was not one of the more common nosocomial strains in Germany. This strain is very common in Romania [ 33 ] and has also been isolated in Germany, Ireland, and Saudi Arabia [ 32 , 34 , 35 , 36 , 37 ]. This may suggest that the MRSA-positive tested person may have been colonized outside the hospital. Thus, it is also possible that the acquisition of MRSA occurred within the hospital.
It has been shown that work clothes, especially the gloves of HCW, are often contaminated with multidrug resistant bacteria during routine care [ 38 , 39 ]. Unfortunately, we do not have data from patient admission screenings and patient MRSA status during the study period. The response rate was rather low Sick leave, vacation and the regular distribution of working times may have prevented a certain proportion of the employees from having a chance to participate in the study.
Study participation was on a voluntarily basis. Although individuals had the opportunity to participate anonymously, some may have declined participation due to a fear of adverse professional consequences, such as fear of stigmatization when tested positive for MRSA.
Recommendations concerning workers that are MRSA carriers range from following standard hygiene procedures to restricting MRSA-colonized workers from working with patients, or even requiring them to take time off from work. Moreover, in exceptional cases, it was reported that employees were fired from work due to permanent MRSA-colonization.
Thus, the fear of stigmatization and job loss may have influenced study participation. However, these recommendations concern work restrictions for MRSA positive staff during outbreaks. In non-outbreak situations, hospitals deal differently with MRSA colonized staff [ 19 ].
National regulations would be helpful for handling MRSA-colonized staff. The major limitations of the study are the small sample size and the low response rate of However, participant characteristics matched general employee characteristics concerning age and sex suggesting low bias.
Furthermore, we only tested staff members, and no patients were tested, making it difficult to make assumptions about the transmission paths [ 40 ]. Also, it would be useful to know whether the same MRSA strains are found in staff and patients.
Another limitation is the cross-sectional study design which may have led to over- or underestimation of MRSA prevalence. Furthermore, we only obtained samples from the anterior nares. It has been shown that screening other body sites increases MRSA yield by about one third over nares alone [ 41 ].
Thus, subjects colonized with MRSA at other body sites e. The results suggest a low prevalence of MRSA in a German cardiac care center in a non-outbreak setting. The results also correspond with the emerging trend of decreasing MRSA carriage prevalence in Europe that may be due to improved hygiene measures.
Nevertheless, there is still a need for national regulations for dealing with MRSA-colonized staff in the healthcare sector. European Centre for Disease Prevention and Control. Antimicrobial resistance surveillance in Europe: Surveillance report. Antimicrobial resistance surveillance in Europe Should healthcare workers be screened routinely for meticillin-resistant Staphylococcus aureus?
A review of the evidence. J Hosp Infect. Cimolai N. The role of healthcare personnel in the maintenance and spread of methicillin-resistant Staphylococcus aureus.
J Infect Public Health. MRSA skin infections can occur in any type of workplace. However, some workplace settings have factors that make it easier for MRSA to be transmitted. Unless directed by a healthcare provider, workers with MRSA infections should not be routinely excluded from going to work. Workers with active infections should be excluded from activities where skin-to-skin contact with the affected skin area is likely to occur until their infections are healed.
What should I do if I suspect that my uniform, clothing, personal protective equipment or workstation has become contaminated with MRSA? Wash uniforms, clothing, sheets and towels that become soiled with water and laundry detergent. Drying clothes in a hot dryer, rather than air-drying, also helps kill bacteria in clothes.
Use a dryer to dry clothes completely. Cleaning contaminated equipment and surfaces with detergent-based cleaners or Environmental Protection Agency EPA -registered disinfectants is effective at removing MRSA from the environment. Most, if not all, disinfectant manufacturers will provide a list of microorganisms on their label that their product can destroy. Because cleaners and disinfectants can be irritating and exposure has been associated with health problems such as asthma, it is important to read the instruction labels on all cleaners to make sure they are used safely and appropriately.
Where disinfection is concerned, more is not necessarily better. EPA has guidance for employers for less hazardous antimicrobial products external icon. Additional information pdf icon external icon is available on effective infection-control practices while minimizing the use of, and exposure to, toxic products in schools written by the National Cleaning for Healthier Schools and Infection Control Workgroup.
Environmental cleaners and disinfectants should not be used to treat infections. What can my boss employers do to prevent the spread of staph or MRSA at the workplace? Staph bacteria, including MRSA, can cause skin infections that may look like a pimple or boil and can be red, swollen, painful, or have pus or other drainage.
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Clin Infect Dis. Considering the introduction of universal MRSA screening. Support Center Support Center. External link. Please review our privacy policy. Specification of the target population. Are study subjects and the setting described? Valid and repeatable disease definition. Are standard measures microbiological and molecular typing methods used for detection of MRSA?
Were confidence intervals or standard errors presented for the estimates of prevalence? Among 33, workers screened in the studies, 4. Most Risk factors included chronic skin diseases, poor hygiene practices, and having worked in countries with endemic MRSA.
Poor infection control practices were linked to both acquisition and transmission of MRSA, the researchers said, but even good adherence to infection control and hand hygiene did not entirely prevent transmission to patients. In fact, several studies were unable to identify any risk factors for MRSA colonization, the researchers said. Of the studies that screened healthcare workers, looked at transmission to patients, Drs.
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