Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infections are associated with increased mortality, costs and length of stay compared to non-MRSA infections. This observational 4-year study analyses the impact of screening and treating orthopaedic healthcare workers for MRSA colonisation. A total of 1,011 swabs were taken from 566 healthcare workers. Positive healthcare workers were treated with topical mupirocin to both anterior nares. The prevalence of MRSA colonisation on initial testing was 4.77%. The rate of positive MRSA colonisation of those tested on more than one occasion fell from 5.88% to 2.71% (p = 0.055) on subsequent screening. All healthcare workers receiving treatment were successfully cleared of colonisation; however, some required more than one course of treatment. These results show that there could be a role for screening and treating orthopaedic staff for MRSA colonisation as part of a strategy to reduce the prevalence of MRSA infections in orthopaedic units.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Stefani S, Varaldo PE (2003) Epidemiology of methicillin-resistant staphylococci in Europe. Clin Microbiol Infect 9(12):1179–1786
Jevons MP, Coe AW, Parker MT (1963) Methicillin resistance in staphylococci. Lancet 1(7287):904–907
Edwards C, Counsell A, Boulton C, Moran CG (2008) Early infection after hip fracture surgery: risk factors, costs and outcome. J Bone Joint Surg Br 90(6):770–777
Roche SJ, Fitzgerald D, O’Rourke A, McCabe JP (2006) Methicillin-resistant Staphylococcus aureus in an Irish orthopaedic centre: a five-year analysis. J Bone Joint Surg Br 88(6):807–811
Albrich WC, Harbarth S (2008) Health-care workers: source, vector, or victim of MRSA? Lancet Infect Dis 8(5):289–301
National Disease Surveillance Centre (2001) A strategy for the control of antimicrobial resistance in Ireland (SARI). National Disease Surveillance Centre, Dublin, Ireland
Cookson B, Peters B, Webster M, Phillips I, Rahman M, Noble W (1989) Staff carriage of epidemic methicillin-resistant Staphylococcus aureus. J Clin Microbiol 27(7):1471–1476
Lessing MP, Jordens JZ, Bowler IC (1996) When should healthcare workers be screened for methicillin-resistant Staphylococcus aureus? J Hosp Infect 34(3):205–210
Coia JE, Duckworth GJ, Edwards DI, Farrington M, Fry C, Humphreys H, Mallaghan C, Tucker DR; Joint Working Party of the British Society of Antimicrobial Chemotherapy; Hospital Infection Society; Infection Control Nurses Association (2006) Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect 63(Suppl 1):S1–S44
Public Health Laboratory Service (1999) Surveillance report: the socio-economic burden of hospital acquired infection. Public Health Laboratory Service, London
Walls RJ, Roche SJ, O’Rourke A, McCabe JP (2008) Surgical site infection with methicillin-resistant Staphylococcus aureus after primary total hip replacement. J Bone Joint Surg Br 90(3):292–298
Blok HE, Troelstra A, Kamp-Hopmans TE, Gigengack-Baars AC, Vandenbroucke-Grauls CM, Weersink AJ, Verhoef J, Mascini EM (2003) Role of healthcare workers in outbreaks of methicillin-resistant Staphylococcus aureus: a 10-year evaluation from a Dutch university hospital. Infect Control Hosp Epidemiol 24(9):679–685
Kunori T, Cookson B, Roberts JA, Stone S, Kibbler C (2002) Cost-effectiveness of different MRSA screening methods. J Hosp Infect 51(3):189–200
Doebbeling BN, Breneman DL, Neu HC, Aly R, Yangco BG, Holley HP Jr, Marsh RJ, Pfaller MA, McGowan JE Jr, Scully BE, Reagan DR, Wenzel RP (1993) Elimination of Staphylococcus aureus nasal carriage in health care workers: analysis of six clinical trials with calcium mupirocin ointment. The Mupirocin Collaborative Study Group. Clin Infect Dis 17(3):466–474
Watanakunakorn C, Axelson C, Bota B, Stahl C (1995) Mupirocin ointment with and without chlorhexidine baths in the eradication of Staphylococcus aureus nasal carriage in nursing home residents. Am J Infect Control 23(5):306–309
Acknowledgements
I would like to thank Barbara Burns, an epidemiologist from the Galway-Mayo Institute of Technology, for her help with analysing the data and comments. I would also like to thank Ramona Neill, an infection control nurse from Mayo General Hospital, for her help in collecting some of the data.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Edmundson, S.P., Hirpara, K.M. & Bennett, D. The effectiveness of methicillin-resistant Staphylococcus aureus colonisation screening in asymptomatic healthcare workers in an Irish orthopaedic unit. Eur J Clin Microbiol Infect Dis 30, 1063–1066 (2011). https://doi.org/10.1007/s10096-011-1192-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-011-1192-3