Schablon Anja, Kleinmüller Olaf, Nienhaus Albert, Peters Claudia
Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Occupational Medicine, Public Health and Hazardous Substances, Statutory Accident Insurance and Prevention in the Health and Welfare Services, Hamburg, Germany.
GMS Hyg Infect Control. 2018 Mar 13;13:Doc03. doi: 10.3205/dgkh000309. eCollection 2018.
Patient transport employees frequently come into contact with multidrug-resistant organisms (MDROs) and therefore are at a greater risk of infection than the general population. These pathogens pose a significant challenge for employees of patient transport services since they can spread over long distances through patient transfers. To date, little is known about the occupational risk of MRSA infection in patient transport settings. A cross-sectional study was conducted to investigate the prevalence of MRSA in patient transport personnel, including taxi drivers, as well as the potential risk factors for MRSA colonization. For screening, nasal swabs were taken. When an individual was tested positive, a control swab was taken; if this confirmed a positive result, decolonization measures were offered. A molecular biological examination of the MRSA samples was performed. A total of 222 patient transport employees were screened and 7 employees tested positive, putting the MRSA prevalence at 3.2% (95% CI 1.4-6.5). Significant risk factors among patient transport staff (PTS) for testing positive were the use of antibiotics (OR 11.9; 95% CI 1.8-78.4) and hospital admission (OR 6.9; 95% CI 1.1-45.9). MRSA swabs were also performed on a total of 102 taxi drivers who provide patient transport services. The MRSA prevalence was 0.98 (95% CI <0.01-5.9). Significant group differences between PTS and taxi drivers, with respect to potential risk factors for MRSA colonization, were identified as inpatient treatment (p=0.09), chronic respiratory illnesses (p=0.01), and knowingly transporting patients/passengers with MRSA (p=0.03). This study is the first to make data on the MRSA risk of patient transport employees in Hamburg available. The prevalence data are low in all areas and indicate a somewhat low risk of infection. A good infection control at the facilities is highly recommendable and the employees should acquire in-depth knowledge of infection prevention to improve compliance with personal protective measures.
患者转运工作人员经常接触多重耐药菌（MDROs），因此比普通人群面临更大的感染风险。这些病原体对患者转运服务的工作人员构成了重大挑战，因为它们可通过患者转运远距离传播。迄今为止，对于患者转运环境中耐甲氧西林金黄色葡萄球菌（MRSA）感染的职业风险知之甚少。开展了一项横断面研究，以调查包括出租车司机在内的患者转运人员中MRSA的流行情况以及MRSA定植的潜在风险因素。筛查时采集鼻拭子。个体检测呈阳性时，采集对照拭子；如果确认结果为阳性，则提供去定植措施。对MRSA样本进行分子生物学检查。共筛查了222名患者转运工作人员，7名工作人员检测呈阳性，MRSA患病率为3.2%（95%置信区间1.4 - 6.5）。患者转运工作人员（PTS）检测呈阳性的显著风险因素是使用抗生素（比值比11.9；95%置信区间1.8 - 78.4）和住院（比值比6.9；95%置信区间1.1 - 45.9）。还对总共102名提供患者转运服务的出租车司机进行了MRSA拭子检测。MRSA患病率为0.98（95%置信区间<0.01 - 5.9）。在MRSA定植的潜在风险因素方面，PTS与出租车司机之间的显著组间差异被确定为住院治疗（p = 0.09）、慢性呼吸道疾病（p = 0.01）以及明知运送携带MRSA的患者/乘客（p = 0.03）。本研究首次提供了汉堡患者转运工作人员MRSA风险的数据。所有领域的患病率数据都很低，表明感染风险 somewhat low（此处原文有误，可能是“较低”之意）。强烈建议各机构做好感染控制，工作人员应深入了解感染预防知识，以提高对个人防护措施的依从性。
