Methicillin resistant Staphylococcus aureus (MRSA) nasal colonization: Could it be a professional restriction?
DOI:
https://doi.org/10.34631/sporl.883Keywords:
nasal carriage MRSA, asymptomatic carrier, health care workers MRSA, asymptomatic MRSA protocol.Abstract
Objectives: Guideline research concerning screening and treatment of MRSA in asymptomatic patients.
Study design: Literature review.
Materials and methods: PubMed search was performed for: “nasal carriage MRSA”, “MRSA health care workers”, “community MRSA”, “MRSA control strategies”.
Results: The screening of colonization by MRSA and the application of decolonization measures in patients of health care units has an impact on decreasing the disease of this microorganism.
There are recommendations for health care professionals screening in order to reduce nosocomial transmission of MRSA, although its application in Portugal is still limited.
Conclusions: Currently, there is no formal indication for treatment of asymptomatic patients. When a professional has nasal colonization with MRSA the indication is to adopt preventive and contact protection measures. We propose a protocol for management of asymptomatic professionals with MRSA in nasal exudate.
References
- El Aila NA, Al Laham NA, Ayesh BM. Nasal carriage of methicillin resistant Staphylococcus aureus among health care workers at Al Shifa hospital in Gaza Strip. BMC Infect Dis. 2017 Jan 5;17(1):28. doi: 10.1186/s12879-016-2139-1.
- Mulcahy ME, Mcloughlin RM. Host—bacterial crosstalk determines Staphylococcus aureus nasal colonization. Trends Microbiol. 2016 Nov;24(11):872-886. doi: 10.1016/j.tim.2016.06.012.
- David MZ, Daum RS. Community-associated Methicillin-Resistant Staphylococcus Aureus: Epidemiology and Clinical Consequences of an Emerging Epidemic. Clin Microbiol Rev. 2010 Jul;23(3):616-87. doi: 10.1128/CMR.00081-09.
- Kock R, Becker K, Cookson B, van Gemert-Pijnen JE. et al.Systematic literature analysis and review of targeted preventive measures to limit healthcare-associated infections by meticillin-resistant Staphylococcus aureus. Euro Surveill. 2014 Jul 24;19(29):20860. doi: 10.2807/1560-7917.es2014.19.29.20860.
- Sakr A, Brégeon F, Mège JL, Rolain JM, Blin O. Staphylococcus aureus Nasal Colonization: An Update on Mechanisms, Epidemiology, Risk Factors, and Subsequent Infections. Front Microbiol. 2018 Oct 8;9:2419. doi: 10.3389/fmicb.2018.02419.
- Albrich WC, Harbarth S. Health-care workers: source, vector, or victim of MRSA? Lancet Infect Dis. 2008 May;8(5):289-301. doi: 10.1016/S1473-3099(08)70097-5.
– Simor AE. Staphylococcal decolonisation: an effective strategy for prevention of infection? Lancet Infect Dis. 2011 Dec;11(12):952-62. doi: 10.1016/S1473-3099(11)70281-X.
– Denis Olivier. Route of transmission of Staphylococcus aureus; Lancet Infect Dis. 2017 Feb;17(2):124-125. doi: 10.1016/S1473-3099(16)30512-6.
– Price JR, Cole K, Bexley A, Kostiou V. et al. Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing. Lancet Infect Dis. 2017 Feb;17(2):207-214. doi: 10.1016/S1473-3099(16)30413-3.
- Abimana JB, Kato CD, Bazira J. Methicillin-Resistant Staphylococcus aureus Nasal Colonization among Healthcare Workers at Kampala International University Teaching Hospital, Southwestern Uganda. Can J Infect Dis Med Microbiol. 2019 Mar 10;2019:4157869. doi: 10.1155/2019/4157869.
- Shibabaw A, Abebe T, Mihret A. Nasal carriage rate of methicillin resistant Staphylococcus aureus among Dessie Referral Hospital Health Care Workers; Dessie, Northeast Ethiopia. Antimicrob Resist Infect Control. 2013 Oct 2;2(1):25. doi: 10.1186/2047-2994-2-25.
- Gurieva TV, Bootsma MC, Bonten MJM. Decolonization of patients and health care workers to control nosocomial spread of methicillin-resistant Staphylococcus aureus: a simulation study. BMC Infect Dis. 2012 Nov 14;12:302. doi: 10.1186/1471-2334-12-302.
-Verwer PE, Robinson JO, Coombs GW, Wijesuriya T. et al. Prevalence of nasal methicillin-resistant Staphylococcus aureus colonization in healthcare workers in a Western Australian acute care hospital. Eur J Clin Microbiol Infect Dis. 2012 Jun;31(6):1067-72. doi: 10.1007/s10096-011-1408-6.
- Amorim ML, Vasconcelos C, Oliveira DC, Azevedo A. et al. Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization among patients and healthcare workers in a Portuguese hospital: a pre-intervention study toward the control of MRSA. Microb Drug Resist. 2009 Mar;15(1):19-26. doi: 10.1089/mdr.2009.0881.
- Elie-Turenne MC, Fernandes H, Mediavilla JR, Rosenthal M. et al. Prevalence and characteristics of Staphylococcus aureus colonization among healthcare professionals in an urban teaching hospital. Infect Control Hosp Epidemiol. 2010 Jun;31(6):574-80. doi: 10.1086/652525.
- Brown AF, Leech JM, Rogers TR, McLoughlin RM. Staphylococcus aureus colonization: modulation of host immune response and impact on human vaccine design. Front Immunol. 2014 Jan 8;4:507. doi: 10.3389/fimmu.2013.00507.
- Vonberg RP, Stamm-Balderjahn S, Hansen S, Zuschneid I. et al. How Often Do Asymptomatic Healthcare Workers Cause Methicillin-Resistant Staphylococcus aureus Outbreaks? A Systematic Evaluation. Infect Control Hosp Epidemiol. 2006 Oct;27(10):1123-7. doi: 10.1086/507922.
- Eveillard M, Martin Y, Hidri N, Boussougant Y. et al. Carriage of methicillin-resistant Staphylococcus aureus among hospital employees: prevalence, duration, and transmission to households. Infect Control Hosp Epidemiol. 2004 Feb;25(2):114-20. doi: 10.1086/502360.
- Ellis MW, Griffith ME, Dooley DP, McLean JC. et al.Targeted intranasal mupirocin to prevent colonization and infection by community-associated methicillin-resistant Staphylococcus aureus strains in soldiers: a cluster randomized controlled trial. Antimicrob Agents Chemother. 2007 Oct;51(10):3591-8. doi: 10.1128/AAC.01086-06.
- Septimus EJ, Schweizer ML. Decolonization in Prevention of Health Care-Associated Infections. Clin Microbiol Rev. 2016 Apr;29(2):201-22. doi: 10.1128/CMR.00049-15.
- Jain R, Kralovic SM, Evans ME, Ambrose M. et al. Veterans Affairs initiative to prevent methicillin-resistant Staphylococcus aureus infections. N Engl J Med. 2011 Apr 14;364(15):1419-30. doi: 10.1056/NEJMoa1007474.
- Simor AE. Staphylococcal decolonisation: an effective strategy for prevention of infection? Lancet Infect Dis. 2011 Dec;11(12):952-62. doi: 10.1016/S1473-3099(11)70281-X.
- Prevenção e Controlo de Colonização e Infeção por Staphylococcus aureus Resistente à Meticilina (MRSA) nos Hospitais e Unidades de Internamento de Cuidados Continuados Integrados. Norma 018/2014. 09/12/2014. Direção Geral da Saúde Disponível em https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0182014-de-09122014.aspx.
- Peres D, Neves I, Vieira F, Devesa I. Estratégia para Controlar o Staphylococcus Aureus Resistente à Meticilina: A Experiência de Cinco Anos de um Hospital. Acta Med Port 2014 Jan-Feb;27(1):67-72.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
