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Updated: Jul 5, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Health-care workers: source, vector, or victim of MRSA?
Werner C Albrich1, Stephan Harbarth
1Respiratory and Meningeal Pathogens Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa.
Abstract:
There is ongoing controversy about the role of health-care workers in transmission of meticillin-resistant Staphylococcus aureus (MRSA). We did a search of the literature from January, 1980, to March, 2006, to determine the likelihood of MRSA colonisation and infection in health-care workers and to assess their role in MRSA transmission. In 127 investigations, the average MRSA carriage rate among 33 318 screened health-care workers was 4.6%; 5.1% had clinical infections. Risk factors included chronic skin diseases, poor hygiene practices, and having worked in countries with endemic MRSA. Both transiently and persistently colonised health-care workers were responsible for several MRSA clusters. Transmission from personnel to patients was likely in 63 (93%) of 68 studies that undertook genotyping. MRSA eradication was achieved in 449 (88%) of 510 health-care workers. Subclinical infections and colonisation of extranasal sites were associated with persistent carriage. We discuss advantages and disadvantages of screening and eradication policies for MRSA control and give recommendations for the management of colonised health-care workers in different settings.
Insights
Health-care workers can carry and transmit meticillin-resistant Staphylococcus aureus (MRSA). Screening and eradication policies are crucial for controlling MRSA transmission in healthcare settings.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Meticillin-resistant Staphylococcus aureus (MRSA) poses a significant challenge in healthcare settings.
- The role of healthcare workers (HCWs) in MRSA transmission remains a subject of debate.
Purpose of the Study:
- To determine the prevalence of MRSA colonization and infection among HCWs.
- To assess the contribution of HCWs to MRSA transmission to patients.
Main Methods:
- Systematic literature review of studies published between January 1980 and March 2006.
- Analysis of MRSA carriage rates, infection rates, and risk factors in HCWs.
- Review of genotyping data to assess transmission events from HCWs to patients.
Main Results:
- Average MRSA carriage rate among 33,318 screened HCWs was 4.6%; 5.1% had clinical infections.
- Risk factors for MRSA carriage included skin diseases, poor hygiene, and prior work in endemic countries.
- Genotyping supported HCW-to-patient transmission in 93% of relevant studies.
Conclusions:
- HCWs can be a source of MRSA transmission, necessitating control strategies.
- Screening and eradication of MRSA in HCWs are effective interventions.
- Management strategies for colonized HCWs should be tailored to different healthcare settings.
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