July 14, 2016
By Will Boggs MD
NEW YORK - Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is common among nurses with occupational skin diseases, researchers from Germany report.
"It was very interesting to see that the prevalence of MRSA carriers among nurses with severe occupational skin diseases is indeed very high," Dr. Richard Brans from the University of Osnabrueck told Reuters Health by email. "Furthermore, our assumption was confirmed that atopic skin diathesis and atopic dermatitis are risk factors for colonization."
Occupational skin diseases are very common on the hands of nurses as a result of a high amount of wet work and skin irritation caused by wearing occlusive gloves and frequent handwashing and disinfections. These skin lesions are at risk of MRSA colonization, but the possibility of a link between occupational skin diseases and MRSA colonization in nurses has not been studied, according to Dr. Brans and colleagues.
The team assessed the prevalence of MRSA colonization, its associated factors, and the effectiveness of MRSA decolonization procedures among 319 nurses who were participating in a tertiary rehabilitation program for severe occupational skin disease.
A total of 43 nurses (13.5%) were colonized with MRSA, including 13.3% of those working in hospitals and 13.7% of those caring for elderly patients.
MRSA colonization rates were higher among nurses with hand eczema (14.2%) than among those with psoriasis of the hands (6.9%).
MRSA was found mainly in the nose (81.4% of those colonized), but the throat was also commonly colonized (30.2% of those colonized), the researchers report in Occupational & Environmental Medicine, online June 29.
Significant risk factors for MRSA carriage included atopic skin diathesis and atopic hand eczema.
MRSA eradication attempts failed after the first treatment cycle in 32.6%, but at least 93% of nurses ultimately had a successful decolonization documented.
"Physicians need to be aware of the increased prevalence of MRSA carriers among nurses with occupational skin diseases, especially among those with severe hand eczema and/or atopic dermatitis," Dr. Brans said.
He added that screening for MRSA colonization could be considered for nurses with occupational skin disease, "at least in those with severe hand eczema and those who report to neglect hand disinfection due to the skin disease."
"Prevention and treatment of occupational skin disease could be important elements in reduction of MRSA prevalence among nurses and transmission to others," the researchers note. "If hygiene procedures cannot be strictly followed by nurses due to occupational skin disease, their assignment in patient care should be restricted."
Occup Environ Med 2016.
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