Methicillin-resistant Staphylococcus aureus acquisition in healthcare workers with cystic fibrosis: a retrospective cross-sectional study

BMC Pulm Med. 2016 May 11;16(1):78. doi: 10.1186/s12890-016-0243-z.

Abstract

Background: People with cystic fibrosis (CF) may work in healthcare settings risking nosocomial pathogen acquisition. The aim of this study was to determine the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in adult healthcare workers with CF (HCWcf).

Methods: Data was collected in this observational study on MRSA acquisition from 405 CF patients attending an adult CF centre in Australia between 2001-2012. Demographic and clinical characteristics were compared between HCWcf and non-HCWcf. A sub-analysis was subsequently performed to compare demographic and clinical characteristics between those patients (HCWcf versus non-HCWcf) that acquired MRSA. We also investigated rates of chronic MRSA infection and the outcome of eradication treatment in HCWcf.

Results: A higher proportion of HCWcf acquired MRSA [n = 10/21] compared to non-HCWcf [n = 40/255] (P <0.001). The odds of MRSA acquisition were 8.4 (95 % CI, 3.0 - 23.4) times greater in HCWcf than non-HCWcf. HCWcf with MRSA were older (P = 0.02) and had better lung function (P = 0.009), yet hospitalisation rates were similar compared to non-HCWcf with MRSA. Chronic MRSA infection developed in 36/50 CF patients (HCWcf, n = 6; non-HCWcf, n = 30), with eradication therapy achieved in 5/6 (83 %) HCWcf.

Conclusions: The rate of MRSA incidence was highest in HCWcf and the workplace is a possible source of acquisition. Vocational guidance should include the potential for MRSA acquisition for CF patients considering healthcare professions.

Keywords: Cystic fibrosis; Employment; Incidence; MRSA; Nosocomial infection.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Australia
  • Cross Infection / drug therapy*
  • Cross Infection / epidemiology*
  • Cross-Sectional Studies
  • Cystic Fibrosis / complications*
  • Female
  • Fusidic Acid / therapeutic use
  • Health Personnel*
  • Humans
  • Incidence
  • Linezolid / therapeutic use
  • Logistic Models
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Multivariate Analysis
  • Retrospective Studies
  • Rifampin / therapeutic use
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / epidemiology*
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Fusidic Acid
  • Linezolid
  • Rifampin