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How Often Do Asymptomatic Healthcare Workers Cause Methicillin-Resistant Staphylococcus aureus Outbreaks? A Systematic Evaluation

Published online by Cambridge University Press:  21 June 2016

Ralf-Peter Vonberg*
Affiliation:
Institute for Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany
Sabine Stamm-Balderjahn
Affiliation:
Institute for Hygiene and Environmental Medicine, Charité-University Medicine, Free University and Humboldt University Berlin, Berlin, Germany
Sonja Hansen
Affiliation:
Institute for Hygiene and Environmental Medicine, Charité-University Medicine, Free University and Humboldt University Berlin, Berlin, Germany
Henning Rüden
Affiliation:
Institute for Hygiene and Environmental Medicine, Charité-University Medicine, Free University and Humboldt University Berlin, Berlin, Germany
Michael Behnke
Affiliation:
Institute for Hygiene and Environmental Medicine, Charité-University Medicine, Free University and Humboldt University Berlin, Berlin, Germany
Petra Gastmeier
Affiliation:
Institute for Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany
*
Institute for Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany, (Vonberg.Ralf@MH-Hannover.DE)

Extract

A systematic search was performed to identify outbreaks of methicillin-resistant Staphylococcus aureus infection and colonization caused by healthcare workers (HCWs). Of 191 outbreaks identified, 11 had strong epidemiological evidence that HCWs were the source. In 3 of these outbreaks, asymptomatic carriers were the cause. The frequent practice of screening asymptomatic HCWs should be reconsidered.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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References

1. National Nosocomial Infections Surveillance System (NNIS). National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004; 32:470485.Google Scholar
2. Cosgrove, SE, Qi, Y, Kaye, KS, Harbarth, S, Karchmer, AW, Carmeli, Y. The impact of methicillin resistance in Staphylococcus aureus bacteremia on patient outcomes: mortality, length of stay, and hospital charges. Infect Control Hosp Epidemiol 2005; 26:166174.Google Scholar
3. Muto, CA, Jernigan, JA, Ostrowsky, BE, et al. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Infect Control Hosp Epidemiol 2003; 24:362386.Google Scholar
4. Blok, HE, Troelstra, A, Kamp-Hopmans, TE, et al. Role of healthcare workers in outbreaks of methicillin-resistant Staphylococcus aureus: a 10-year evaluation from a Dutch university hospital. Infect Control Hosp Epidemiol 2003; 24:679685.Google Scholar
5. Harberg, D. Society for Healthcare Epidemiology of America guideline approach works to control a methicillin-resistant Staphylococcus aureus outbreak. Infect Control Hosp Epidemiol 2005; 26:115116.CrossRefGoogle ScholarPubMed
6. Gastmeier, P, Stamm-Balderjahn, S, Hansen, S, et al. How outbreaks can contribute to prevention of nosocomial infection: analysis of 1,022 outbreaks. Infect Control Hosp Epidemiol 2005; 26:357361.Google Scholar
7. Faibis, F, Laporte, C, Fiacre, A, et al. An outbreak of methicillin-resistant Staphylococcus aureus surgical-site infections initiated by a healthcare worker with chronic sinusitis. Infect Control Hosp Epidemiol 2005; 26:213215.Google Scholar
8. Berthelot, P, Grattard, F, Fascia, P, et al. Implication of a healthcare worker with chronic skin disease in the transmission of an epidemic strain of methicillin-resistant Staphylococcus aureus in a pediatric intensive care unit. Infect Control Hosp Epidemiol 2003; 24:299300.Google Scholar
9. Wang, JT, Chang, SC, Ko, WJ, et al. A hospital-acquired outbreak of methicillin-resistant Staphylococcus aureus infection initiated by a surgeon carrier. J Hosp Infect 2001; 47:104109.Google Scholar
10. Andersen, BM, Bergh, K, Steinbakk, M, et al. A Norwegian nosocomial outbreak of methicillin-resistant Staphylococcus aureus resistant to fusidic acid and susceptible to other antistaphylococcal agents. J Hosp Infect 1999;41:123132.Google Scholar
11. Sheretz, RJ, Reagan, DR, Hampton, KD, et al. A cloud adult: the Staphylococcus aureus–virus interaction revisited. Ann Intern Med 1996; 124:539547.Google Scholar
12. Boyce, JM, Opal, SM, Potter-Bynoe, G, Medeiros, AA. Spread of methicillin-resistant Staphylococcus aureus in a hospital after exposure to a health care worker with chronic sinusitis. Clin Infect Dis 1993; 17:496504.Google Scholar
13. Richardson, JF, Quoraishi, AH, Francis, BJ, Marples, RR. Beta-lactamase-negative, methicillin-resistant Staphylococcus aureus in a newborn nursery: report of an outbreak and laboratory investigations. J Hosp Infect 1990; 16:109121.Google Scholar
14. Coovadia, YM, Bhana, RH, Johnson, AP, Haffejee, I, Marples, RR. A laboratory-confirmed outbreak of rifampicin-methicillin resistant Staphylococcus aureus (RMRSA) in a newborn nursery. J Hosp Infect 1989; 14:303312.CrossRefGoogle Scholar
15. Meier, PA, Carter, CD, Wallace, SE, Hollis, RJ, Pfaller, MA, Herwaldt, LA. A prolonged outbreak of methicillin-resistant Staphylococcus aureus in the burn unit of a tertiary medical center. Infect Control Hosp Epidemiol 1996; 17:798802.Google Scholar
16. Lessing, MP, Jordens, JZ, Bowler, IC. Molecular epidemiology of a multiple strain outbreak of methicillin-resistant Staphylococcus aureus amongst patients and staff. J Hosp Infect 1995; 31:253260.Google Scholar
17. Gaynes, R, Marosok, R, Mowry-Hanley, J, et al. Mediastinitis following coronary artery bypass surgery: a 3-year review. J Infect Dis 1991; 163:117121.Google Scholar
18. Cookson, B, Peters, B, Webster, M, Phillips, I, Rahman, M, Noble, W. Staff carriage of epidemic methicillin-resistant Staphylococcus aureus . J Clin Microbiol 1989; 27:14711476.Google Scholar
19. Cox, RA, Conquest, C. Strategies for the management of healthcare staff colonized with epidemic methicillin-resistant Staphylococcus aureus . J Hosp Infect 1997; 35:117127.Google Scholar
20. Kreiswirth, B, Kornblum, J, Arbeit, RD, et al. Evidence for a clonal origin of methicillin resistance in Staphylococcus aureus . Science 1993; 259:227230.Google Scholar