Methicillin-resistant Staphylococcus aureus in Ohio EMS Providers: A Statewide Cross-sectional Study
Methicillin-resistant Staphylococcus aureus in Ohio EMS Providers: A Statewide Cross-sectional Study
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DOI：
10.3109/10903127.2015.1076098
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发表时间：
2016-03-03
影响因子：
2.4
通讯作者：
Stevenson, Kurt B.
中科院分区：
文献类型：
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作者：
Orellana, Robert C.;Hoet, Armando E.;Stevenson, Kurt B.
目的是确定紧急医疗服务（EMS）人员鼻腔携带耐甲氧西林金黄色葡萄球菌（MRSA）的流行情况及其相关危险因素。横断面研究是在俄亥俄州的84个城市和农村机构中随机抽取的EMS人员中进行的。用鼻拭子收集调查对象的人口统计、职业史、健康状况、同居状况和卫生习惯。进行调查权重调整分析(1)估计俄亥俄州EMS提供者的MRSA鼻腔携带患病率，(2)确定与MRSA相关的变量。EMS人员MRSA检出率为4.6%（13/280）。采用调查加权分析后，确定了与MRSA携带相关的以下危险因素：手套使用后不经常洗手的人（OR, 10.51; 95% CI, 2.54-43.45; P = 0.0012），与最近感染葡萄球菌的人一起生活（OR, 9.02; 95% CI, 1.03-78.98; P = 0.0470），以及洗手频率较低的人（每班少于8次）（OR, 4.20; 95% CI, 1.02-17.27; P = 0.0468）。通过对研究人群的logistic回归分析确定的另一个危险因素是有开放性伤口或皮肤感染的EMS工作人员（or, 6.75; 95% CI, 1.25-36.36; P = 0.0262）。然而，这在调查加权分析中并不显著。MRSA在俄亥俄州EMS人员中的高流行率既是一种职业危害，也是患者安全问题。实施方法加强疾病预防控制中心的指导方针，适当的卫生可以减少MRSA发现在EMS设置。以前的文献表明，减少MRSA定植可以减少传播，改善患者和工作人员的健康。
The objective was to determine the nasal carriage prevalence of methicillin-resistant Staphylococcus aureus (MRSA) among emergency medical service (EMS) personnel and the associated risk factors. A cross-sectional study was conducted among Ohio EMS personnel randomly sampled from 84 urban and rural agencies. Surveys assessing demographics, occupational history, health, cohabitation status, and hygiene practice were collected with nasal swabs from those who enrolled. Survey weight adjusted analysis was performed (1) to estimate MRSA nasal carriage prevalence of Ohio EMS providers, and (2) to identify variables associated with MRSA. MRSA was detected in 4.6% (13/280) EMS personnel sampled. After employing a survey-weighted analysis the following risk factors associated with MRSA carriage were identified: those who did not practice frequent hand hygiene after glove use (OR, 10.51; 95% CI, 2.54-43.45; P = 0.0012), living with someone with a recent staphylococcal infection (OR, 9.02; 95% CI, 1.03-78.98; P = 0.0470), and individuals with low frequency of hand washing (< 8times per shift) (OR, 4.20; 95% CI 1.02-17.27; P = 0.0468). An additional risk factor identified through the logistic regression analysis on the study population was EMS workers with an open wound or skin infection (OR, 6.75; 95% CI, 1.25-36.36; P = 0.0262). However, this was not significant in the survey-weighted analysis. The high prevalence of MRSA in Ohio EMS personnel is both an occupational hazard and patient safety concern. Implementing methods to reinforce CDC guidelines for proper hygiene could decrease MRSA found in the EMS setting. Previous literature suggests that a reduction in MRSA colonization can lead to decreases in transmission and improved health for both patients and personnel.