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Occupational Determinants of Methicillin-Resistant Staphylococcus aureus Colonization Among Healthcare Workers: A Longitudinal Study in a Rehabilitation Center

Published online by Cambridge University Press:  18 March 2015

J. Legrand ,
L. Temime ,
C. Lawrence ,
J. L. Herrmann ,
P. Y. Boelle  and
D. Guillemot
J. Legrand*
Affiliation:
Univ Paris-Sud, UMR 0320/UMR8120 Génétique Quantitative et Evolution—Le Moulon, F-91190 Gif-sur-Yvette, France
L. Temime
Affiliation:
Laboratoire MESuRS, Conservatoire national des Arts et Métiers, F-75003 Paris, France
C. Lawrence
Affiliation:
Service de Microbiologie, Hôpital Raymond Poincaré, Assistance Publique—Hôpitaux de Paris, F-92380, Garches, France
J. L. Herrmann
Affiliation:
Service de Microbiologie, Hôpital Raymond Poincaré, Assistance Publique—Hôpitaux de Paris, F-92380, Garches, France INSERM U1173, UFR Simone Veil, Versailles-Saint-Quentin University, 78180 Saint-Quentin en Yvelines, France
P. Y. Boelle
Affiliation:
INSERM, U1136, Paris, France Sorbonne Universités, UPMC Univ. Paris 6, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris, France
D. Guillemot
Affiliation:
Inserm UMR 1181 “Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases” (B2PHI), F-75015 Paris, France Institut Pasteur, UMR 1181, B2PHI, F-75015 Paris, France Univ. Versailles St Quentin, UMR 1181, B2PHI, F-78180 Montigny-le-Bretonneux AP-HP, Raymond Poincare Hospital, F-92380 Garches, France. Members of the iBird Study Group are listed at the end of the text
*
Address correspondence to Judith Legrand, PhD, Génétique Quantitative et Évolution—Le Moulon, INRA—Univ Paris-Sud—CNRS—AgroParisTech, Ferme du Moulon, F-91190 Gif-sur-Yvette, France ([email protected]).
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Abstract

BACKGROUND

Staphylococcus aureus carriage among healthcare workers (HCWs) is a concern in hospital settings, where it may provide a reservoir for later infections in both patients and staff. Earlier studies have shown that the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage in HCWs is highly variable, depending notably on location, hospital department type, MRSA prevalence among patients, and type of contacts with patients. However, MRSA incidence in HCWs and its occupational determinants have seldom been studied.

METHODS

A prospective, observational cohort study was conducted between May and October 2009 in a French rehabilitation center hospital. HCWs and patients were screened weekly for S. aureus nasal carriage. Methicillin-susceptible S. aureus and MRSA prevalence and incidence were estimated and factors associated with MRSA acquisition were identified using generalized estimating equation regression methods.

RESULTS

Among 343 HCWs included in the analysis, the average prevalence was 27% (95% CI, 24%–29%) for methicillin-susceptible S. aureus and 10% (8%–11%) for MRSA. We observed 129 MRSA colonization events. According to the multivariable analysis, high MRSA prevalence level among patients and HCW occupation were significantly associated with MRSA acquisition in HCWs, with assistant nurses being more at risk than nurses (odds ratio, 2.2; 95% CI, 1.4–3.6).

CONCLUSIONS

Our findings may help further our understanding of the transmission dynamics of MRSA carriage acquisition in HCWs, suggesting that it is notably driven by carriage among patients and by the type of contact with patients.

Infect Control Hosp Epidemiol 2015;36(7):767–776

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 7 , July 2015 , pp. 767 - 776
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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