【柳叶刀】Health-care workers: source, vector, or victim of MRSA?
Lancet Infect Dis 2008;8: 289–301【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 diff erent settings.
看不懂英文，最好弄个中文版的。
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