Bischoff Werner E, Tucker Brian K, Wallis Michelle L, Reboussin Beth A, Pfaller Michael A, Hayden Frederick G, Sherertz Robert J
Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Infect Control Hosp Epidemiol. 2007 Oct;28(10):1148-54. doi: 10.1086/520734. Epub 2007 Aug 29.
Transmission of Staphylococcus aureus via air may play an important role in healthcare settings. This study investigates the impact of barrier precautions on the spread of airborne S. aureus by volunteers with experimentally induced rhinovirus infection (ie, the common cold).
Prospective nonrandomized study.
Wake Forest University School of Medicine (Winston-Salem, NC).Participants. A convenience sample of 10 individuals with nasal S. aureus carriage selected from 593 students screened for carriage.
Airborne S. aureus dispersal was studied in the 10 participants under the following clothing conditions: street clothes, surgical scrubs, surgical scrubs and a gown, and the latter plus a face mask. After a 4-day baseline period, volunteers were exposed to a rhinovirus, and their clinical course was followed for 12 days. Daily swabs of nasal specimens, pharynx specimens, and skin specimens were obtained for quantitative culture, and cold symptoms were documented. Data were analyzed by random-effects negative binomial models.
All participants developed a common cold. Incidence rate ratios (IRRs) indicated that, compared with airborne levels of S. aureus during sessions in which street clothes were worn, airborne levels decreased by 75% when surgical scrubs were worn (P<.001), by 80% when scrubs and a surgical gown were worn (P<.001), and by 82% when scrubs, a gown, and a face mask were worn (P<.001). The addition of a mask to the surgical scrubs and gown did not reduce the airborne dispersal significantly (IRR, 0.92; P>.05). Male volunteers shed twice as much S. aureus as females (incidence rate ratio, 2.04; P=.013). The cold did not alter the efficacy of the barrier precautions.
Scrubs reduced the spread of airborne S. aureus, independent of the presence of a rhinovirus-induced cold. Airborne dispersal of S. aureus during sessions in which participants wore surgical scrubs was not significantly different from that during sessions in which gowns and gowns plus masks were also worn.
金黄色葡萄球菌通过空气传播可能在医疗机构中起重要作用。本研究调查了屏障预防措施对感染实验性鼻病毒（即普通感冒）的志愿者传播空气中金黄色葡萄球菌的影响。
前瞻性非随机研究。
维克森林大学医学院（北卡罗来纳州温斯顿 - 塞勒姆）。
从593名接受携带筛查的学生中选取的10名鼻腔携带金黄色葡萄球菌的个体组成的便利样本。
在以下着装条件下研究10名参与者空气中金黄色葡萄球菌的扩散情况：便服、手术服、手术服加手术袍，以及后者加口罩。在4天的基线期后，志愿者接触鼻病毒，并对其临床病程进行12天的跟踪。每天采集鼻拭子、咽拭子和皮肤拭子进行定量培养，并记录感冒症状。数据采用随机效应负二项式模型进行分析。
所有参与者都患上了普通感冒。发病率比（IRR）表明，与穿着便服时空气中金黄色葡萄球菌水平相比，穿着手术服时空气中水平下降了75%（P<0.001），穿着手术服加手术袍时下降了80%（P<0.001），穿着手术服、手术袍加口罩时下降了82%（P<0.001）。在手术服和手术袍上加戴口罩并没有显著降低空气中的扩散（IRR，0.92；P>0.05）。男性志愿者排出的金黄色葡萄球菌是女性的两倍（发病率比，2.04；P = 0.013）。感冒并未改变屏障预防措施的效果。
手术服减少了空气中金黄色葡萄球菌的传播，与鼻病毒引起的感冒无关。参与者穿着手术服时空气中金黄色葡萄球菌的扩散与穿着手术袍以及手术袍加口罩时的扩散没有显著差异。
