Peters Claudia, Kleinmüller Olaf, Nienhaus Albert, Schablon Anja
Institute for Health Services Research in Dermatology and Nursing, University Medical Centre 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.
BMJ Open. 2018 Jul 16;8(7):e021204. doi: 10.1136/bmjopen-2017-021204.
Healthcare workers frequently come into contact with infected individuals and are at a greater risk of infection than the general population due to their occupation. Multidrug-resistant organisms (MDROs) also pose a significant challenge for personnel and medical facilities. Currently, little is known about the occupational risk of methicillin-resistant (MRSA) in outpatient care settings. Therefore, a cross-sectional study was conducted in Hamburg to investigate MRSA colonisation among outpatient nursing staff.
MRSA screening with nasal swabs was carried out, the known risk factors for colonisation were determined and information on infection control was inquired. Where tests were positive, a control swab was taken; if this confirmed a positive result, decolonisation was offered. A molecular biological examination of the MRSA samples was performed. The occupational MRSA exposure and risk factors were compared with the situation for personnel in inpatient geriatric care.
A total of 39 outpatient services participated in the study and 579 employees were tested. The MRSA prevalence was 1.2% in all and 1.7% in nursing staff. Most of the employees that tested positive had close or known contact with MRSA patients. Health personnel frequently reported personal protective measures and their application. Compared with inpatient care staff, outpatient staff were older and had worked in their profession for a longer time.
This study marks the first time that data has been made available on the occupational MRSA risk of outpatient care personnel in Hamburg. The MRSA prevalence is low and provides a good basis for describing the MRSA risk of occupational exposure by health personnel in outpatient care.
医护人员经常接触感染个体，因其职业原因，他们比普通人群面临更高的感染风险。多重耐药菌（MDROs）也给工作人员和医疗设施带来了重大挑战。目前，对于门诊护理环境中耐甲氧西林金黄色葡萄球菌（MRSA）的职业风险知之甚少。因此，在汉堡进行了一项横断面研究，以调查门诊护理人员中的MRSA定植情况。
采用鼻拭子进行MRSA筛查，确定已知的定植风险因素，并询问感染控制方面的信息。检测呈阳性时，采集对照拭子；如果对照拭子确认结果为阳性，则提供去定植治疗。对MRSA样本进行分子生物学检查。将职业性MRSA暴露和风险因素与老年住院护理人员的情况进行比较。
共有39个门诊服务机构参与了该研究，对579名员工进行了检测。总体MRSA患病率为1.2%，护理人员中为1.7%。大多数检测呈阳性的员工与MRSA患者有密切或已知接触。卫生人员经常报告个人防护措施及其应用情况。与住院护理人员相比，门诊工作人员年龄较大，从事该职业的时间更长。
本研究首次提供了汉堡门诊护理人员职业性MRSA风险的数据。MRSA患病率较低，为描述门诊护理中卫生人员职业暴露的MRSA风险提供了良好依据。
