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Updated: Jun 21, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Prevalence of methicillin sensitive and resistant Staphylococcus aureus carriage among German emergency medical
Aaron Weiss1, Axel Kramer1, Robert Taube2
1Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
Background:
Health care workers (HCW) in Emergency Medical Services (EMS) frequently come into contact with carriers of methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) strains and may acquire and transmit them to patients. However, there is little data on MSSA and MRSA colonization of medical personnel in the emergency services. Additionally, few studies have analyzed the association between personal hygiene of staff and colonization. Therefore, we examined the prevalence of MSSA and MRSA in EMS staff of two German regions and evaluated their personal hygiene behavior.
Method:
Throat and nasal swabs from 300 EMS workers were analyzed. Both direct and pre-enriched cultures of the swabs were cultivated on culture media to identify MSSA and MRSA. Results were analyzed together with questionnaires about sociodemographic data and a self-assessment of hygiene behavior. Statistical analysis was done using the R statistical software.
Results:
Of the total 300 swabs, 55% were from paramedics, 39% were from emergency medical technicians (EMT) and 5% were from emergency physicians. With 1%, the MRSA prevalence was comparable to that of the German population, while the MSSA rate - 43.7% - was higher than expected. Colonization with MSSA was significantly associated with poor hand hygiene and male sex, and was inversely correlated to time on the job in EMS.
Conclusion:
The sample size of 300 and a MRSA prevalence of 1% made a meaningful analysis of potential influencing factors on the prevalence of MRSA infeasible. The comparatively high prevalence of MSSA and the association with decreasing frequency of hand antisepsis suggests an influence of personal hygiene on MSSA colonization. HCW in EMS should be encouraged to make use of their personal protective equipment and practice frequent hand hygiene. The implementation of diagnostic tools such as the Hand Hygiene Self-Assessment Framework of the WHO could be utilized to reveal problems in organizations, followed by an individual program to promote hand hygiene.
Insights
Methicillin-susceptible Staphylococcus aureus (MSSA) colonization is common in emergency medical services (EMS) staff, linked to poor hand hygiene. Frequent hand hygiene and proper personal protective equipment use are crucial for healthcare workers (HCW) in EMS.
Area of Science:
- Microbiology
- Public Health
- Occupational Health
Background:
- Emergency Medical Services (EMS) personnel frequently encounter carriers of Staphylococcus aureus (S. aureus).
- Limited data exists on S. aureus colonization (both methicillin-susceptible and methicillin-resistant strains) among EMS staff.
- The relationship between personal hygiene practices and S. aureus colonization in EMS workers requires further investigation.
Purpose of the Study:
- To determine the prevalence of methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) colonization in EMS staff.
- To evaluate the personal hygiene behaviors of EMS workers.
- To explore potential associations between hygiene practices and S. aureus colonization.
Main Methods:
- Analysis of throat and nasal swabs from 300 EMS workers using direct and pre-enriched cultures.
- Collection of sociodemographic data and self-assessed hygiene behavior via questionnaires.
- Statistical analysis of prevalence and influencing factors using R software.
Main Results:
- MRSA prevalence was 1%, similar to the general German population.
- MSSA prevalence was 43.7%, higher than anticipated.
- MSSA colonization was significantly associated with poorer hand hygiene and male sex, and inversely correlated with years of service in EMS.
Conclusions:
- The high MSSA prevalence and its association with hand hygiene suggest personal hygiene influences colonization.
- Frequent hand hygiene and consistent use of personal protective equipment are recommended for EMS staff.
- Implementing tools like the WHO Hand Hygiene Self-Assessment Framework can identify organizational issues and promote better hygiene practices.
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