Headlines: April 15th, 2008

Research published today concludes that more aggressive screening of health care workers would help bring down rates of MRSA infection in hospitals in combination with other infection control measures. The suggestion is made in a review in the May issue of ‘The Lancet Infectious Diseases’.

In the review, ‘Health-care workers: source, vector, or victim of MRSA’, Stephan Harbarth, from the Infection Control Programme at the University Hospitals of Geneva, and Werner Albrich, from the University of the Witwaters and in South Africa, have analysed data from 169 studies from 37 countries to determine what part health care workers play in passing on the infection.

They found that 4.6 per cent of the workers in the study carried MRSA and of those just over five per cent had clinical MRSA infections.

The authors say, “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 colonised staff to patients.”

They reveal how health workers can release substantial clouds of MRSA into the air when they have upper respiratory tract infections. In those circumstances, patients with large open wounds are at high risk of airborne MRSA infection. They also looked at how community-associated MRSA and healthcare-acquired MRSA have spread to people who have been in close contact with health care workers. This, they say, not only entails risk for family members but can lead to further spread of the infection.

They argue that screening should not be limited to those care workers who are known to be infected and suggest it should take place irrespective of the presence of risk factors as part of a pre-employment examination or, in the case of large outbreaks, periodically and unannounced before a shift begins. They say, “Screening and eradication of health-care workers’ MRSA status should always be part of a comprehensive infection control policy including staff education and emphasising high compliance with hand hygiene and contact precautions.”