Reduktion von nosokomialen MRSA-Fällen/Infektionen in 37 Akutkliniken der Maximal-, Regel- und Grundversorgung durch strikte Einhaltung der Basishygienemaßnahmen

Biedermann, Kristina; Becker-Boost, E.; Herrmann, M; Rieke, Elmar; Wirtz, Klaus; Rüden, H.

doi:10.1016/j.khinf.2011.07.001

Cited by 1 publication

(2 citation statements)

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“…However, this specific topic is given a low level of evidence [10], as the effectiveness of different screening strategies for considering staff (or patients) free from MRSA carriage remains controversial [1,2,7]. In a few German studies, clinical infection control professionals have reported that they do not require MRSA-colonised HCWs to be removed from patient care, provided that the affected HCWs comply with basic infection control measures [18,19]. However, these in-house regulations did not apply during outbreaks or when colonised HCWs were suffering from chronic skin diseases [18] or were working in high-risk units [19].…”

Section: Discussionmentioning

confidence: 99%

“…In a few German studies, clinical infection control professionals have reported that they do not require MRSA-colonised HCWs to be removed from patient care, provided that the affected HCWs comply with basic infection control measures [18,19]. However, these in-house regulations did not apply during outbreaks or when colonised HCWs were suffering from chronic skin diseases [18] or were working in high-risk units [19]. German recommendations for facilities outside the clinical setting, for nursing homes or domestic care, consider that adherence to the basic principles of hand hygiene is the most important measure and allow colonised HCWs to continue to work [20].…”

Section: Discussionmentioning

confidence: 99%

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Involvement of occupational physicians in the management of MRSA-colonised healthcare workers in Germany – a survey

Dulon

Haamann

Nienhaus

2013

Journal of Occupational Medicine and Toxicology

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BackgroundColonisation of healthcare workers (HCWs) with methicillin-resistant Staphylococcus aureus strains (MRSA) is a challenge for any healthcare facility. Persistent carriage of MRSA among HCWs causes special problems, particularly in occupational-medical care. German occupational physicians responsible for healthcare facilities were therefore asked about their experience in managing MRSA-colonised HCWs.MethodsIn May 2012, 549 occupational physicians were asked in writing about in-house management of MRSA-colonised HCWs. The semi-standardised survey form contained questions about collaboration between the infection control team and the occupational physician, the involvement of the occupational physician in in-house management of MRSA carriers and the number of persistently colonised HCWs in 2011. The answers were intended to apply to the largest facility cared for by the occupational physician.Results207 occupational physicians took part in the survey (response rate 38%). In 2011, 73 (35%) occupational physicians were responsible for the occupational-medical management of an average of four MRSA-colonised HCWs. Eleven doctors (5.3% of 207) managed a total of 17 persistently colonised HCWs. One of these 17 employees was dismissed. In the case of MRSA carriage among HCWs, most occupational physicians cooperated with the infection control team (77%) and 39% of occupational physicians were responsible for the occupational-medical management of the affected carrier. 65% of facilities had specified policies for the management of MRSA-colonised HCWs. After the first MRSA-positive screening result, 79% of facilities attempt to decolonise the affected employee. In 6% of facilities, the colonised HCWs were excluded from work while receiving decolonisation treatment. In 54% of facilities, infection control policies demand the removal of MRSA carriers from patient care.ConclusionsNot all facilities have policies for the management of MRSA-colonised HCWs and there are major differences in occupational consequences for the affected HCWs. In order to protect both the employees and the patients, standards for the in-house management of MRSA colonisation in HCWs should be developed.

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