MRSA, Staph, Staff, Mersa, Methicillin Resistant Staphylococcus Aureus Symptoms & Treatment

Italians seek to keep hospital staff MRSA free

Link: HighWire Press -- Medline Abstract.

Methicillin-resistant Staphylococcus Aureus (MRSA) is a type of Staphylococcus that is resistant to certain antibiotics. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin. Staphylococcus infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities. The present study was performed to investigate the in vitro activity of oxacillin and other antimicrobial agents against S. aureus strains obtained from nursing personnel. The study included 56 hospital personnel of Universitary Policlinic of Messina. S. aureus strain was isolated in 14 samples (25%); resistent patterns have been studied and results have demonstrated: none methicillin resistant, while 14% oxacillin and tetraciclin resistant. The incidence of methicillin sensitive was 100%, while 86% proved to be sensitive to oxacillin and tetraciclin. In conclusion, the usually hygienic methods (disposable gowns, hygienic hand disinfection after each patients contact, masks use when is a risk of aerosolization of MRSA) are indicate for significantly reducing of these strains. Continuing education programmes can help to increase awareness among hospital staff.

Colonised Staff Pass on MRSA despite Hand Hygiene & Masks

Link: Review Urges Aggressive MRSA Screening for Health Workers - washingtonpost.com.

"Poor infection control practices were implicated in both acquisition and transmission of MRSA by personnel, but even good adherence to infection control -- including masks and hand hygiene -- did not entirely prevent transmission of MRSA from heavily colonized staff to patients," they wrote. A recent review of MRSA outbreaks suggested that health-care worker screening should focus on those with symptoms of MRSA infection, but this approach would likely miss a large number of MRSA-infected workers with no symptoms, the review authors said. "Screening of infected health-care workers only will likely miss a large number of asymptomatic personnel capable of transmitting MRSA to patients, since staphylococcal carriage is mainly dependent on whether the person is a nasal carrier (of MRSA)... Our search revealed 18 studies with proven, and 26 studies with likely, transmission to patients from (health-care workers) who were not clinically infected with MRSA," the authors wrote.

1 in 400 hospital workers have active MRSA infection

Link: Am I Passing MRSA to My Patients? - Journal Watch Emergency Medicine.

Methicillin-resistant Staphylococcus aureus (MRSA) has become ubiquitous in emergency departments, but the role of healthcare workers in its transmission is unclear. To assess likelihood of MRSA colonization, infection, and transmission among healthcare workers, researchers performed a comprehensive literature search and identified 127 investigations involving 33,318 screened healthcare workers. Only 18 studies failed to detect MRSA in healthcare workers. Inadequate hand-washing, chronic skin diseases, and having worked in countries with endemic MRSA were identified as risk factors for MRSA carriage. The overall MRSA carriage rate was 4.6%, and most colonization was on the hands or in the nasopharynx of affected healthcare workers. Of these carriers, 5.1% had clinical infections. Healthcare-worker transmission of MRSA to patients was deemed likely in 63 of 68 studies (93%) that performed genotyping. Transmission occurred from both transiently and persistently colonized workers. Eight studies documented transmission to workers’ family members. According to data from one systematic review, nasal mupirocin led to MRSA eradication in 91% of 143 treated workers within 48 to 96 hours.

Medical staff 3 times more likely to be MRSA carriers

Link: Nurses, staff should receive MRSA screenings, researchers say - McKnight's Long Term Care News.

Leaders of healthcare facilities should seriously consider having staff members screened for MRSA, the drug-resistant infection that can wreak havoc on senior populations, Swiss and South African researchers say. Worker screenings for Methicillin-resistant Staphylococcus aureus (MRSA) should be conducted "irrespective of the presence of risk factors or pus-producing infections as part of pre-employment examination, or [especially during large MRSA outbreaks] even periodically and unannounced before a work shift," study authors wrote. They found 4.6% of workers carried MRSA. Of those, 5.1% had clinical MRSA infections. Researchers reviewed information from 169 studies in 37 countries, encompassing more than 33,300 individuals, to reach their conclusions. "Poor infection control practices were implicated in both acquisition and transmission of MRSA by personnel, but even good adherence to infection control -- including masks and hand hygiene -- did not entirely prevent transmission of MRSA from heavily colonized staff to patients," they wrote.

MRSA-infected medics allowed to keep working

Link: MRSA-infected medics allowed to keep working - Health News, Health & Wellbeing - The Independent.

Hospital trusts are allowing doctors and nurses to continue treating patients even after testing positive for potentially lethal superbugs including MRSA. Hundreds of trusts do not take their staff off wards automatically if they are found to be carrying one of the most virulent hospital bugs, methicillin-resistant Staphylococcus aureus (MRSA), which can be spread by human contact. A survey of trusts carried out by The Independent on Sunday revealed that few routinely screen staff for the infection, or even keep records of the number of employees infected with MRSA. They claimed such a policy was fully in line with government guidelines. The approach is backed by many unions – including one that warned that a hardline policy could damage its members' financial well-being and career prospects.

1 in 6 Hospital staff are MRSA carriers

Link: HighWire Press -- Medline Abstract.

To compare the sensitivity of various protocols for methicillin-resistant Staphylococcus aureus (MRSA) surveillance, active surveillance for detecting MRSA nasal colonization was performed on 97 members of the medical staff and 218 patients in the Intensive Care Unit (ICU) of a university hospital. Duplicate nasal swabs were collected from each participant. One was plated directly on a blood agar plate (D-BAP) and observed at 24 and 48 hr. Another was incubated overnight in tryptic soy broth (TSB) with 6.5% NaCl, and subcultured on both BAP (B-BAP) and mannitol salt agar with 4 mg/L of oxacillin (B-MSAOXA). The MRSA colonization rate was similar in the medical staff and patient samples (16.5% vs 11.9%, p = 0.285). Among the medical staff members, the sensitivity of MRSA detection was the same (93.8%) in D-BAP and B-BAP. In the ICU patients, which are a high-risk group, the sensitivity of MRSA detection was improved by adding a pre-enrichment step (73.1% on D-BAP vs 96.2% on B-BAP). The simple direct plating protocol was sufficiently sensitive for the medical staff members, but pre-enrichment was an essential step to increase detection of MRSA in the ICU patients.

1 in 6 ICU staff MRSA carriers?

Link: Comparison of Protocols for Surveillance of Methicillin-resistant Staphylococcus aureus (MRSA): Medical Staff vs ICU Patients -- Lee et al. 37 (3): 248 -- Annals of Clinical and Laboratory Science.

The MRSA colonization rate was similar in the medical staff and patient samples (16.5% vs 11.9%, p = 0.285). Among the medical staff members, the sensitivity of MRSA detection was the same (93.8%) in D-BAP and B-BAP. In the ICU patients, which are a high-risk group, the sensitivity of MRSA detection was improved by adding a pre-enrichment step (73.1% on D-BAP vs 96.2% on B-BAP). The simple direct plating protocol was sufficiently sensitive for the medical staff members, but pre-enrichment was an essential step to increase detection of MRSA in the ICU patients.

15% of staff carriers of infection?

Link: Long Persistence of Methicillin-Susceptible Strains of Staphylococcus aureus Causing Sepsis in a Neonatal Intensive Care Unit -- Gomez-Gonzalez et al. 45 (7): 2301 -- Journal of Clinical Microbiology.

Molecular epidemiology of Staphylococcus aureus strains causing bacteremia in neonates during 2002 to 2005 revealed seven clones, with four MSSA clones responsible for 80% of the cases. Some clones persisted or reappeared throughout the study. Three bacteremic clones were found colonizing health care workers (HCWs), particularly clone C, which was harbored by at least 15% of HCWs.

Hospital Staff MRSA Super Carriers?

Link: Press Release

Another topic that was not openly addressed at the conference is why APIC does not recommend universal screening of healthcare personnel. One issue is the potential legal liability if a patient learns that a physician may have been the source of a serious infection. Furthermore, some Sates have reporting requirements that would necessitate the physician taking work leave until the MRSA were cleared. These self-protective attitudes seem foolhardy when one considers the medical risk an MRSA carrying physician poses to him or herself and to other staff, family and community members. Moreover, it is unreasonable to extend a hospital's reluctance for self-testing to nurses, nursing aids, ward personnel and janitorial support staff. Complacency on this issue may also reflect the usual assumption that only sick patients are really at risk for serious MRSA infections. Unlike earlier strains, today's MRSA generally produce a powerful toxin, termed PVL. Upon inadvertant entry of MRSA into even healthy tissues, this toxin can readily overcome the body's defenses leading to an invasive and occasionally flesh-eating disease. Whether out of ignorance or for other reasons, the emphasis is still being placed on the antibiotic resistance of MRSA, rather than on the more recently acquired capacity for toxin production. Carriage of toxic MRSA is also likely to be a determining factor in the severity of the pneumonia that can complicate influenza, including the anticipated bird flu epidemic.

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3% of staff permenant MRSA carriers?

Link: HighWire Press -- Medline Abstract.

Between October 2001 and February 2002, 324 healthcare workers were screened for methicillin-resistant Staphylococcus aureus (MRSA) by nose and throat swabs. A positive finding led to activation of a standardised control programme for the affected person who was immediately excluded from work. Family members of those who were MRSA-positive were offered screening free of charge. An eradication programme was carried out in the permanent carriers. MRSA was found in 17 (5.3%) healthcare workers, 11 of whom proved to be permanent carriers, and six temporarily colonised. Three children of a positive healthcare worker showed nasopharyngeal MRSA, the acquisition of which occurred within the hospital. The standardised eradication programme for carriers was successful in most cases but failed in two individuals, whereupon systemic antibiotics were used successfully. The decolonised carriers, observed for more than one year, remained MRSA negative. Isolation precautions in hospitals do not always prevent hospital staff and their families from acquiring MRSA. The identification of affected employees is difficult because in most cases only asymptomatic colonisation occurs. Screening and eradication can be complicated and costly, and for the affected employees the occupational consequences can be far-reaching as they have no guaranteed legal protection.