Kaminski A, Kammler J, Wick M, Muhr G, Kutscha-Lissberg F
Department of Orthopaedics, Chirurgische Klinik und Poliklinik, Berrgmannsheil, Universitätsklinik, Bürkle-de-la-Camp-Platz 1, 447899 Bochum, Germany.
J Bone Joint Surg Br. 2007 May;89(5):642-5. doi: 10.1302/0301-620X.89B5.18756.
Between October 2001 and February 2002, 324 healthcare workers were screened for methicillin-resistant Staphylococcus aureus (MRSA) by nose and throat swabs. A positive finding led to activation of a standardised control programme for the affected person who was immediately excluded from work. Family members of those who were MRSA-positive were offered screening free of charge. An eradication programme was carried out in the permanent carriers. MRSA was found in 17 (5.3%) healthcare workers, 11 of whom proved to be permanent carriers, and six temporarily colonised. Three children of a positive healthcare worker showed nasopharyngeal MRSA, the acquisition of which occurred within the hospital. The standardised eradication programme for carriers was successful in most cases but failed in two individuals, whereupon systemic antibiotics were used successfully. The decolonised carriers, observed for more than one year, remained MRSA negative. Isolation precautions in hospitals do not always prevent hospital staff and their families from acquiring MRSA. The identification of affected employees is difficult because in most cases only asymptomatic colonisation occurs. Screening and eradication can be complicated and costly, and for the affected employees the occupational consequences can be far-reaching as they have no guaranteed legal protection.
2001年10月至2002年2月期间，通过鼻拭子和咽拭子对324名医护人员进行了耐甲氧西林金黄色葡萄球菌（MRSA）筛查。检测结果呈阳性会启动针对受感染人员的标准化控制程序，该人员会立即被禁止工作。MRSA检测呈阳性者的家庭成员可免费接受筛查。针对长期携带者实施了根除计划。在17名（5.3%）医护人员中发现了MRSA，其中11人被证实为长期携带者，6人为暂时定植。一名呈阳性的医护人员的三个孩子鼻咽部检测出MRSA，感染发生在医院内。针对携带者的标准化根除计划在大多数情况下是成功的，但有两人失败，随后使用全身抗生素成功治愈。对已清除定植的携带者进行了一年多的观察，他们的MRSA检测仍为阴性。医院的隔离预防措施并不总能防止医院工作人员及其家人感染MRSA。识别受感染的员工很困难，因为在大多数情况下，仅有无症状定植发生。筛查和根除可能复杂且成本高昂，对受影响的员工而言，职业后果可能很严重，因为他们没有得到保障的法律保护。
