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Colonisation with methicillin-resistant Staphylococcus aureus and associated factors among nurses with occupational skin diseases
  1. Richard Brans1,2,
  2. Katarzyna Kolomanski1,2,
  3. Franziska Mentzel1,2,
  4. Ulrike Vollmer1,
  5. Olaf Kaup1,
  6. Swen Malte John1,2
  1. 1Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
  2. 2Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
  1. Correspondence to Dr Richard Brans, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Sedanstr. 115, Osnabrück 49090, Germany; rbrans{at}uos.de

Abstract

Objectives To evaluate the prevalence of colonisation with methicillin-resistant Staphylococcus aureus (MRSA), associated factors and the effectiveness of decolonisation procedures among nurses with occupational skin diseases (OSD).

Methods In a retrospective cohort study, the medical records of 319 nurses from Germany who were screened consecutively for MRSA when participating in a tertiary individual prevention programme (TIP) for severe OSD between July 2009 and December 2014 were evaluated.

Results 90.3% of nurses with severe OSD suffered from hand eczema. 43 were colonised with MRSA on admission (13.5%), mainly in the nose (n=35, 81.4%). However, the hands were affected in more than half of the MRSA carriers (n=24, 55.8%). Risk factors for MRSA colonisation were atopic skin diathesis (OR 2.01, 95% CI 1.03 to 3.92, p=0.049) and presence of atopic dermatitis on other body parts than the hands (OR 4.33, 95% CI 2.23 to 8.43, p<0.001). Hand eczema was significantly more severe in MRSA carriers than in non-carriers (OR 1.23, 95% CI 1.10 to 1.37, p<0.001) and showed a higher prevalence of vesicles, erosions or fissures. MRSA eradication was successful in 67.4% after the first attempt.

Conclusions Nurses with OSD have a twofold to threefold higher prevalence of MRSA colonisation than what has been reported for point-prevalence screenings among healthcare workers in Germany. Atopic skin diathesis, atopic dermatitis and severe hand eczema are the main risk factors. Thus, prevention and treatment of OSD could be important elements in reduction of colonisation with MRSA among nurses and transmission to others.

  • MRSA
  • Staphylococcus aureus
  • occupational skin diseases
  • nurses

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