Health Protection Scotland, Glasgow, UK.
J Hosp Infect. 2011 Apr;77(4):285-9. doi: 10.1016/j.jhin.2010.09.038. Epub 2011 Feb 2.
Meticillin-resistant Staphylococcus aureus (MRSA) is considered endemic in the UK National Health Service (NHS), and routine MRSA screening of hospital inpatients has recently been introduced in both Scotland and England. The UK National Screening Committee states that public pressure for widening the eligibility criteria of a proposed screening programme should be anticipated and any related decisions scientifically justifiable. A literature review was conducted to examine whether MRSA screening in Scotland should be expanded to include the routine screening of healthcare workers (HCWs). There are no published prevalence studies reporting the overall MRSA carriage rate in HCWs in NHS hospitals. Estimates of HCW carriage from the worldwide literature vary widely depending on the country, hospital specialty and setting (endemic, non-endemic or outbreak). Recent studies conducted in endemic hospital settings report non-outbreak carriage rates of 0-15%. The role of HCW carriage in the transmission of MRSA is not well understood. Persistent carriage could act as a reservoir for infection and HCWs have been implicated as the source in a number of published outbreak reports. There are no published controlled trials examining the impact of routine HCW screening as an intervention in the prevention and control of MRSA infections in the endemic hospital setting. Most of the evidence for HCW screening comes from outbreak reports where the outbreak was brought to an end following the introduction of staff screening as part of a suite of infection control measures. Further research is required before a recommendation could be made to introduce routine MRSA screening of HCWs in the NHS in Scotland.
耐甲氧西林金黄色葡萄球菌（MRSA）在英国国家医疗服务体系（NHS）中被认为是地方性的，苏格兰和英格兰最近都引入了对住院患者进行常规 MRSA 筛查。英国国家筛查委员会指出，应该预料到公众对扩大拟议筛查计划的资格标准的压力，并且任何相关决策都应该具有科学合理性。进行了文献综述，以检查苏格兰是否应该扩大 MRSA 筛查范围，包括对医护人员（HCWs）的常规筛查。没有发表的流行率研究报告 NHS 医院中 HCWs 的总体 MRSA 携带率。来自全球文献的 HCW 携带估计值因国家、医院专业和环境（地方性、非地方性或暴发）而异。在地方性医院环境中进行的最近研究报告的非暴发携带率为 0-15%。HCW 携带在 MRSA 传播中的作用尚未得到很好的理解。持续携带可能成为感染的蓄水池，并且 HCWs 已被牵连为许多已发表的暴发报告中的传染源。没有发表的对照试验研究常规 HCW 筛查作为预防和控制地方性医院环境中 MRSA 感染的干预措施的影响。HCW 筛查的大部分证据来自暴发报告，在引入员工筛查作为一系列感染控制措施的一部分后，暴发得到了控制。在向苏格兰 NHS 建议引入常规 MRSA 筛查 HCWs 之前，需要进一步研究。
