Green Bart N, Johnson Claire D, Egan Jonathon Todd, Rosenthal Michael, Griffith Erin A, Evans Marion Willard
Chiropractor, Chiropractic Division, Department of Physical and Occupational Therapy, Naval Medical Center, San Diego, CA.
J Chiropr Med. 2012 Mar;11(1):64-76. doi: 10.1016/j.jcm.2011.12.001.
Methicillin-resistant Staphylococcus aureus (MRSA) is associated with difficult-to-treat infections and high levels of morbidity. Manual practitioners work in environments where MRSA is a common acquired infection. The purpose of this review is to provide a practical overview of MRSA as it applies to the manual therapy professions (eg, physical and occupational therapy, athletic training, chiropractic, osteopathy, massage, sports medicine) and to discuss how to identify and prevent MRSA infections in manual therapy work environments.
PubMed and CINAHL were searched from the beginning of their respective indexing years through June 2011 using the search terms MRSA, methicillin-resistant Staphylococcus aureus, and Staphylococcus aureus. Texts and authoritative Web sites were also reviewed. Pertinent articles from the authors' libraries were included if they were not already identified in the literature search. Articles were included if they were applicable to ambulatory health care environments in which manual therapists work or if the content of the article related to the clinical management of MRSA.
Following information extraction, 95 citations were included in this review, to include 76 peer-reviewed journal articles, 16 government Web sites, and 3 textbooks. Information was organized into 10 clinically relevant categories for presentation. Information was organized into the following clinically relevant categories: microbiology, development of MRSA, risk factors for infection, clinical presentation, diagnostic tests, screening tests, reporting, treatment, prevention for patients and athletes, and prevention for health care workers.
Methicillin-resistant S aureus is a health risk in the community and to patients and athletes treated by manual therapists. Manual practitioners can play an essential role in recognizing MRSA infections and helping to control its transmission in the health care environment and the community. Essential methods for protecting patients and health care workers include being aware of presenting signs, patient education, and using appropriate hand and clinic hygiene.
耐甲氧西林金黄色葡萄球菌(MRSA)与难以治疗的感染及高发病率相关。手法治疗从业者工作的环境中,MRSA是常见的获得性感染源。本综述的目的是提供一份关于MRSA的实用概述,阐述其在手法治疗专业领域(如物理治疗与职业治疗、运动训练、整脊疗法、骨疗法、按摩、运动医学)中的情况,并探讨如何在手法治疗工作环境中识别和预防MRSA感染。
通过使用搜索词MRSA、耐甲氧西林金黄色葡萄球菌和金黄色葡萄球菌,在PubMed和CINAHL数据库中从各自索引起始年份至2011年6月进行检索。同时也查阅了相关文献及权威网站。若作者文库中的相关文章未在文献检索中被识别,则将其纳入。若文章适用于手法治疗师工作的门诊医疗环境,或其内容与MRSA的临床管理相关,则予以纳入。
经过信息提取,本综述纳入了95篇文献,包括76篇经同行评审的期刊文章、16个政府网站和3本教科书。信息被整理成10个临床相关类别进行呈现。这些类别包括:微生物学、MRSA的发展、感染风险因素、临床表现、诊断测试、筛查测试、报告、治疗、患者和运动员的预防以及医护人员的预防。
耐甲氧西林金黄色葡萄球菌对社区以及接受手法治疗师治疗的患者和运动员构成健康风险。手法治疗从业者在识别MRSA感染以及帮助控制其在医疗环境和社区中的传播方面可发挥重要作用。保护患者和医护人员的基本方法包括留意症状表现、开展患者教育以及保持适当的手部和诊所卫生。