Hospital Pharmacist
2008;15:158
May 2008

News summary

Health staff transfer MRSA to patients

Healthcare workers carrying meticillin-resistant Staphylococcus aureus can cause MRSA outbreaks, a study suggests (The Lancet Infectious Diseases 2008;8:289–301).

The authors reviewed 169 articles that discussed the colonisation or infection of healthcare workers with MRSA, between January 1980 and March 2006. The articles originated in 37 countries — most of which were high income countries.

Of these articles, 120 documented the number of healthcare workers that were screened for infection, which gave a cumulative total of 33,318 workers.

Transmission of infection from worker to patient was evaluated in 106 studies. Of these, 27 reported clear evidence of such transmission, and a further 52 studies concluded that it was likely. Transmission of infection to patients from workers who were not showing clinical symptoms was noted in 44 studies.

One study linked a healthcare worker with an upper respiratory tract MRSA infection to an outbreak involving eight patients on a surgical intensive care unit.

The authors conclude that healthcare workers should be screened for MRSA if they work at a hospital that is experiencing an outbreak, or that is located in an area where MRSA infections are endemic. Infected workers should be prescribed standard eradication treatment.

The authors also recommend that workers should be routinely screened before starting employment, and that random screening of staff before a work shift begins should be considered. Screening would routinely involve swabbing the nose and throat, but could potentially involve cultures taken from the perineum or rectum, if increased sensitivity was desired.