title: Methicillin-resistant Staphylococcus aureus acquisition in healthcare workers with cystic fibrosis: a retrospective cross-sectional study.
abstract: BACKGROUND
  People with cystic fibrosis (CF) may work in healthcare settings risking nosocomial pathogen acquisition. The aim of this study was to determine the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in adult healthcare workers with CF (HCWcf).
  
  
  METHODS
  Data was collected in this observational study on MRSA acquisition from 405 CF patients attending an adult CF centre in Australia between 2001-2012. Demographic and clinical characteristics were compared between HCWcf and non-HCWcf. A sub-analysis was subsequently performed to compare demographic and clinical characteristics between those patients (HCWcf versus non-HCWcf) that acquired MRSA. We also investigated rates of chronic MRSA infection and the outcome of eradication treatment in HCWcf.
  
  
  RESULTS
  A higher proportion of HCWcf acquired MRSA [n = 10/21] compared to non-HCWcf [n = 40/255] (P <0.001). The odds of MRSA acquisition were 8.4 (95 % CI, 3.0 - 23.4) times greater in HCWcf than non-HCWcf. HCWcf with MRSA were older (P = 0.02) and had better lung function (P = 0.009), yet hospitalisation rates were similar compared to non-HCWcf with MRSA. Chronic MRSA infection developed in 36/50 CF patients (HCWcf, n = 6; non-HCWcf, n = 30), with eradication therapy achieved in 5/6 (83 %) HCWcf.
  
  
  CONCLUSIONS
  The rate of MRSA incidence was highest in HCWcf and the workplace is a possible source of acquisition. Vocational guidance should include the potential for MRSA acquisition for CF patients considering healthcare professions.
authors.affiliation: Lung Bacteria Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD, 4006, Australia. michelle.wood2@health.qld.gov.au.|Adult Cystic Fibrosis Centre, The Prince Charles Hospital, 627 Rode Road, Chermside, Brisbane, QLD, 4032, Australia. michelle.wood2@health.qld.gov.au.|School of Medicine, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia. michelle.wood2@health.qld.gov.au.
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Wood
authors.affiliation: Lung Bacteria Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD, 4006, Australia.|CF & Airways Microbiology Group, School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Sherrard
authors.affiliation: Lung Bacteria Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD, 4006, Australia.|School of Medicine, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia.
authors.forename: Kay A
authors.initials: KA
authors.lastname: Ramsay
authors.affiliation: School of Medicine, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia.|Queensland Lung Transplant Service, The Prince Charles Hospital, Brisbane, QLD, 4032, Australia.
authors.forename: Stephanie T
authors.initials: ST
authors.lastname: Yerkovich
authors.affiliation: Adult Cystic Fibrosis Centre, The Prince Charles Hospital, 627 Rode Road, Chermside, Brisbane, QLD, 4032, Australia.|Lung Inflammation and Infection Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD, 4006, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Reid
authors.affiliation: Centre for Experimental Medicine, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.|School of Chemistry and Molecular Biosciences, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4072, Australia.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Kidd
authors.affiliation: Lung Bacteria Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD, 4006, Australia.|Adult Cystic Fibrosis Centre, The Prince Charles Hospital, 627 Rode Road, Chermside, Brisbane, QLD, 4032, Australia.|School of Medicine, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Bell
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001315:Australia; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D005672:Fusidic Acid / Q000627:therapeutic use; D006282:Health Personnel; D006801:Humans; D015994:Incidence; D000069349:Linezolid / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D005672:Fusidic Acid; D000069349:Linezolid; D012293:Rifampin
keywords: Cystic fibrosis; Employment; Incidence; MRSA; Nosocomial infection