Gutovitz Scott, Hart Leslie, Parisio-Poldiak Nayda, Smith Morgan, Dickson Lexus, Warrington Steven, Thacker Stephen, Janke Amanda
Emergency Medicine, Grand Strand Medical Center, Myrtle Beach, USA.
Department of Health and Human Performance, College of Charleston, Charleston, USA.
Cureus. 2021 Sep 14;13(9):e17958. doi: 10.7759/cureus.17958. eCollection 2021 Sep.
Background Methicillin-resistant (MRSA) can colonize up to 14.5% of healthcare workers (HCWs). The colonization rate of HCWs or the hospital setting that contributes most to MRSA colonization is less clear. In this study, we studied new resident physicians (PGY-1), as a model for HCWs, to measure their colonization rate and hypothesized that the incidence of colonization would increase during their first year. Methodology We prospectively enrolled PGY-1 residents of multiple specialties at three academic medical centers. After obtaining informed consent, PGY-1 residents were tested for MRSA in June 2019 before starting any clinical rotations and then retested every three to four months thereafter. The coronavirus disease 2019 pandemic forced us to end the study early. If MRSA-positive, residents were treated with 2% mupirocin and retested for a cure. For comparison, upper-level residents (PGY-2-5) were also enrolled to obtain a baseline prevalence of colonization. Results We enrolled 80 PGY-1 and 81 PGY-2-5 residents in the study. The baseline prevalence of MRSA colonization was 4.94% (4/81) in PGY-2-5 residents and 2.50% (2/80) for new PGY-1 residents; however, this was not statistically significant (p = 0.68). The cumulative yearly incidence of developing MRSA colonization in PGY-1 residents was 4.51%. MRSA colonization was successfully treated in 75% of cases. Conclusions PGY-1 residents had a lower MRSA colonization rate compared to PGY-2-5 residents, although this was not statistically significant. PGY-1 residents had a small incidence of developing MRSA colonization while working in the hospital. Further research is needed to determine if this is clinically relevant to HCWs or their patients.
耐甲氧西林金黄色葡萄球菌（MRSA）可定植于高达14.5%的医护人员（HCWs）。医护人员的定植率或对MRSA定植贡献最大的医院环境尚不清楚。在本研究中，我们以新住院医师（PGY-1）作为医护人员的模型，测量他们的定植率，并假设定植发生率在他们的第一年中会增加。方法：我们前瞻性地招募了三个学术医疗中心多个专业的PGY-1住院医师。在获得知情同意后，PGY-1住院医师于2019年6月在开始任何临床轮转之前接受MRSA检测，此后每三到四个月重新检测一次。2019年冠状病毒病大流行迫使我们提前结束研究。如果MRSA呈阳性，住院医师用2%莫匹罗星治疗并重新检测以确定是否治愈。为作比较，还招募了高年级住院医师（PGY-2至5）以获得定植的基线患病率。结果：我们在研究中招募了80名PGY-1住院医师和81名PGY-2至5住院医师。PGY-2至5住院医师中MRSA定植的基线患病率为4.94%（4/81），新PGY-1住院医师为2.50%（2/80）；然而，这在统计学上无显著差异（p = 0.68）。PGY-1住院医师发生MRSA定植的累积年发病率为4.51%。75%的病例中MRSA定植得到成功治疗。结论：与PGY-2至5住院医师相比，PGY-1住院医师的MRSA定植率较低，尽管这在统计学上无显著差异。PGY-1住院医师在医院工作期间发生MRSA定植的发生率较低。需要进一步研究以确定这在临床上是否与医护人员或其患者相关。
