Prevalence and risk factors of MRSA colonisations: a cross-sectional study among personnel in outpatient care settings in Hamburg, Germany

BMJ Open. 2018 Jul 16;8(7):e021204. doi: 10.1136/bmjopen-2017-021204.

Abstract

Objectives: Healthcare workers frequently come into contact with infected individuals and are at a greater risk of infection than the general population due to their occupation. Multidrug-resistant organisms (MDROs) also pose a significant challenge for personnel and medical facilities. Currently, little is known about the occupational risk of methicillin-resistant Staphylococcus aureus (MRSA) in outpatient care settings. Therefore, a cross-sectional study was conducted in Hamburg to investigate MRSA colonisation among outpatient nursing staff.

Methods: MRSA screening with nasal swabs was carried out, the known risk factors for colonisation were determined and information on infection control was inquired. Where tests were positive, a control swab was taken; if this confirmed a positive result, decolonisation was offered. A molecular biological examination of the MRSA samples was performed. The occupational MRSA exposure and risk factors were compared with the situation for personnel in inpatient geriatric care.

Results: A total of 39 outpatient services participated in the study and 579 employees were tested. The MRSA prevalence was 1.2% in all and 1.7% in nursing staff. Most of the employees that tested positive had close or known contact with MRSA patients. Health personnel frequently reported personal protective measures and their application. Compared with inpatient care staff, outpatient staff were older and had worked in their profession for a longer time.

Conclusion: This study marks the first time that data has been made available on the occupational MRSA risk of outpatient care personnel in Hamburg. The MRSA prevalence is low and provides a good basis for describing the MRSA risk of occupational exposure by health personnel in outpatient care.

Keywords: MRSA; colonisation; health personnel; infection control; outpatient care.

MeSH terms

  • Adult
  • Ambulatory Care Facilities
  • Carrier State / epidemiology*
  • Carrier State / microbiology
  • Cross-Sectional Studies
  • Female
  • Germany / epidemiology
  • Health Personnel / statistics & numerical data*
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus*
  • Middle Aged
  • Nose / microbiology
  • Nursing Staff / statistics & numerical data
  • Occupational Diseases / epidemiology*
  • Occupational Diseases / microbiology
  • Occupational Exposure*
  • Prevalence
  • Risk Factors
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology