MRSA in Healthcare Workers

MRSA in Healthcare Workers

Two studies showed a high prevalence of MRSA colonization among emergency department healthcare workers.

Recent studies have revealed an increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in the general population; in a 2003–2004 U.S. national survey, 1.5% of participants had nasal carriage of this pathogen (JW Infect Dis Apr 23 2008). What is the prevalence of MRSA carriage among healthcare workers, whose risk for MRSA exposure is elevated? Now, researchers have explored this issue in two investigations involving emergency departments.

Suffoletto and colleagues conducted a prospective convenience-sample survey from October through December 2006 among emergency department healthcare workers in five Pittsburgh teaching hospitals. Individuals with a known recent S. aureus infection, or a hospitalization within the previous year, were excluded. Among the 255 participants, 81 (31.8%) had nasal colonization with S. aureus, including 11 (4.3%) with MRSA. All MRSA-colonized workers were nurses, nursing assistants, or patient-care technicians.

Bisaga and colleagues conducted a similar study from May through September 2006 at a tertiary care community teaching hospital near Chicago, using a PCR assay for MRSA. Nasal MRSA colonization was found in 16 of 105 participants (15.2%), with no statistically significant difference in prevalence among nurses, physicians, and technicians.

Comment: The authors of both studies acknowledge potential selection bias introduced by the use of a convenience sample, and neither study included the molecular typing necessary to differentiate between community- and healthcare-associated MRSA strains. Additionally, given the increasing incidence of MRSA infections, the rates of nasal colonization in these healthcare workers may not have been higher than those in the general populations in their communities. Still, these findings emphasize the need for vigilance against MRSA infections in healthcare workers and for good infection-control practices among workers to protect both patients and themselves.

— Richard T. Ellison III, MD

Published in Journal Watch Infectious Diseases June 25, 2008

Citation(s):

Bisaga A et al. A prevalence study of methicillin-resistant Staphylococcus aureus colonization in emergency department health care workers. Ann Emerg Med 2008 Apr 25; [e-pub ahead of print]. (http://dx.doi.org/10.1016/j.annemergmed.2008.03.019)

Suffoletto BP et al. Prevalence of Staphylococcus aureus nasal colonization in emergency department personnel. Ann Emerg Med 2008 Apr 25; [e-pub ahead of print]. (http://dx.doi.org/10.1016/j.annemergmed.2008.03.020)