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Infection with methicillin-resistant Staphylococcus aureus among hospital employees
R R Muder1, C Brennen, A M Goetz
1Infectious Disease Section, VA Medical Center, Pittsburgh, PA 15240.
Objective:
To describe the spectrum of clinical infection caused by methicillin-resistant Staphylococcus aureus (MRSA) in healthcare workers.
Design:
Case series.
Setting:
Two Veterans Affairs hospitals in which methicillin-resistant S aureus (MRSA) is endemic.
Patients:
Five employees presenting to employee health or infectious disease clinic.
Results:
All employees had had direct exposure to patients colonized with MRSA. Employee infections included cellulitis, impetigo, folliculitis, paronychia, and conjunctivitis. MRSA was isolated from all clinically infected sites and from the anterior nares of two employees. Three employees received a variety of ineffective oral antimicrobials before MRSA was recognized as the causative agent. All infections responded to appropriate therapy.
Conclusions:
Employees of hospitals with endemic MRSA may acquire MRSA infection. Presentation in our employees was that of relatively uncomplicated soft tissue infection, but several employees received inappropriate therapy before bacteriologic diagnosis. We recommend that culture and susceptibility testing be obtained prior to institution of therapy when hospital employees present with soft tissue infection.
Insights
Healthcare workers in hospitals with endemic methicillin-resistant Staphylococcus aureus (MRSA) can contract MRSA infections. Early diagnosis and appropriate therapy are crucial for effective treatment of these soft tissue infections.
Area of Science:
- Infectious Diseases
- Occupational Health
- Microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in healthcare settings.
- Understanding MRSA transmission in healthcare workers (HCWs) is critical for infection control.
Observation:
- A case series involving five healthcare employees in two Veterans Affairs hospitals with endemic MRSA.
- All affected employees had direct patient contact with MRSA-colonized individuals.
Findings:
- Clinical presentations included cellulitis, impetigo, folliculitis, paronychia, and conjunctivitis.
- MRSA was confirmed in clinical isolates and nasal swabs; some employees received ineffective antimicrobial treatments initially.
- All infections resolved with appropriate antimicrobial therapy and diagnostic measures.
Implications:
- Healthcare workers in MRSA-endemic environments are at risk for acquiring MRSA infections, primarily soft tissue infections.
- Prompt diagnosis through culture and susceptibility testing is recommended for soft tissue infections in HCWs to ensure effective treatment and prevent complications.
- This highlights the importance of stringent infection control protocols and employee health surveillance in healthcare facilities managing MRSA.