Duong Thuy B, Duong Minh C, Campbell James I, Nguyen Hoang V M, Nguyen Hien H, Bui Hanh T B, Nguyen Chau V V, Heywood Anita
Hospital for Tropical Diseases, Ho Chi Minh City - Vietnam.
School of Population Health, University of New South Wales, Sydney, New South Wales - Australia.
Drug Target Insights. 2022 Dec 31;16:71-77. doi: 10.33393/dti.2022.2504. eCollection 2022 Jan-Dec.
: Little is known about the magnitude and patterns of methicillin-resistant (MRSA) carriage among intensive care unit (ICU) healthcare workers (HCWs), especially in lower-middle-income countries like Vietnam.
: A prospective cohort study was conducted on HCWs working in the adult ICU of the Hospital for Tropical Diseases in Vietnam between October 28 and December 20, 2019. These HCWs included physicians, nurses, and nursing assistants who were responsible for all essential medical activities and basic patient care. A questionnaire was used to collect participants’ information, including age, sex, profession, ICU working time, and underlying diseases. Hand and nasal swabs were collected weekly for 8 consecutive weeks for MRSA screening. Staphylococcal isolates were checked for catalase and coagulase and, for methicillin resistance using cefoxitin disk diffusion, then rechecked on the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.
: Among 55 HCWs, 16 (29.1%) carried MRSA in their noses or hands. MRSA intermittent hand carriage was documented in 2 (3.6%) HCWs. Among 53 HCWs undertaking nasal swabs, 13 (24.5%) were MRSA persistent and 3 (5.6%) were intermittent carriers. The MRSA carriage rate was highest among nursing assistants (50%, 4/8). More HCWs with underlying diseases were found to be MRSA carriers (31.8%, 7/22) compared with those without comorbidities (27.3%, 9/33).
: MRSA carriage among HCWs is not rare. The findings highlight an urgent need to review and update the local infection prevention and control measures to prevent MRSA transmission from HCWs to patients.
对于重症监护病房（ICU）医护人员（HCWs）中耐甲氧西林金黄色葡萄球菌（MRSA）携带的程度和模式知之甚少，尤其是在越南等中低收入国家。
于2019年10月28日至12月20日对在越南热带病医院成人ICU工作的医护人员进行了一项前瞻性队列研究。这些医护人员包括负责所有基本医疗活动和基本患者护理的医生、护士和护理助理。使用问卷调查收集参与者的信息，包括年龄、性别、职业、ICU工作时间和基础疾病。连续8周每周采集手部和鼻腔拭子进行MRSA筛查。对葡萄球菌分离株进行过氧化氢酶和凝固酶检测，并使用头孢西丁纸片扩散法检测耐甲氧西林情况，然后在基质辅助激光解吸/电离飞行时间质谱仪上重新检测。
在55名医护人员中，16人（29.1%）鼻腔或手部携带MRSA。2名（3.6%）医护人员有MRSA间歇性手部携带记录。在53名接受鼻腔拭子检测的医护人员中，13人（24.5%）为MRSA持续携带者，3人（5.6%）为间歇性携带者。护理助理中的MRSA携带率最高（50%，4/8）。与无合并症的医护人员（27.3%，9/33）相比，更多有基础疾病的医护人员被发现为MRSA携带者（31.8%，7/22）。
医护人员中MRSA携带并不罕见。研究结果凸显了迫切需要审查和更新当地的感染预防和控制措施，以防止MRSA从医护人员传播给患者。
