Nathaus Rolf, Schulz Jochen, Hartung Jörg, Cuny Christiane, Fetsch Alexandra, Blaha Thomas, Meemken Diana
Tierärztliche Gemeinschaftspraxis Vet-Team-Reken, Reke.
Berl Munch Tierarztl Wochenschr. 2011 Mar-Apr;124(3-4):128-35.
The study presents first experiences on the controlled use of respiratory masks against Methicillin-resistant Staphylococcus aureus (MRSA) in a multi-person veterinary pig practice. Seven veterinarians entered the trial (five wearing masks, two wearing no masks) after the veterinarians had performed a decolonisation protocol. The pig herds were visited regularly by the veterinarians during the study period. The five "trial" veterinarians wore gloves and respiratory masks for at least 30 days and 30 farm visits. The two "control" veterinarians wore gloves only. Nasal swabs were collected at a seven day interval. Swabs and ten masks per "trial" veterinarian were bacteriologically tested for MRSA including MLST- and spa-typing. The study showed a high MRSA-exposure for the veterinarians, since 68% of the masks were tested positive for MRSA. However, four vets stayed MRSA-negative while using the masks. Only one of the"trial" veterinarians became positive after two weeks. After the masks were not worn any more, two veterinarians returned to colonisation soon again. The two "control" veterinarians turned positive after 26 and 54 days, respectively. The high finding-rates of MRSA in the masks proof an enormous risk of nasal colonisation during routine work.The results of our study do not proof the potential of respiratory masks to prevent nasal colonisation of veterinarians with MRSA. However, there are no hints, that the proper use of masks could be a risk factor for becoming colonised. Further details of the proper use of masks and the quantification of their protective potential need further studies on a larger scale.
该研究展示了在多人参与的兽医养猪实践中，对使用呼吸面罩控制耐甲氧西林金黄色葡萄球菌（MRSA）感染的初步经验。在兽医们执行了去定植方案后，七名兽医参与了试验（五人佩戴口罩，两人不戴口罩）。在研究期间，兽医们定期走访猪群。五名“试验”兽医佩戴手套和呼吸面罩至少30天，并进行30次农场走访。两名“对照”兽医仅佩戴手套。每隔七天采集一次鼻拭子。对每名“试验”兽医的拭子和十个口罩进行MRSA细菌学检测，包括多位点序列分型（MLST）和葡萄球菌蛋白A分型（spa分型）。研究表明，兽医面临的MRSA暴露风险很高，因为68%的口罩经检测MRSA呈阳性。然而，四名兽医在使用口罩期间MRSA检测保持阴性。只有一名“试验”兽医在两周后检测呈阳性。在不再佩戴口罩后，两名兽医很快又重新出现定植。两名“对照”兽医分别在26天和54天后检测呈阳性。口罩中MRSA的高检出率证明了日常工作中鼻腔定植的巨大风险。我们的研究结果并未证明呼吸面罩有预防兽医被MRSA鼻腔定植的潜力。然而，没有迹象表明正确佩戴口罩会成为定植的风险因素。关于口罩正确使用的更多细节及其防护潜力的量化，需要进一步开展更大规模的研究。
