title: Colonisation with methicillin-resistant Staphylococcus aureus and associated factors among nurses with occupational skin diseases.
abstract: OBJECTIVE
  To evaluate the prevalence of colonisation with methicillin-resistant Staphylococcus aureus (MRSA), associated factors and the effectiveness of decolonisation procedures among nurses with occupational skin diseases (OSD).
  
  
  METHODS
  In a retrospective cohort study, the medical records of 319 nurses from Germany who were screened consecutively for MRSA when participating in a tertiary individual prevention programme (TIP) for severe OSD between July 2009 and December 2014 were evaluated.
  
  
  RESULTS
  90.3% of nurses with severe OSD suffered from hand eczema. 43 were colonised with MRSA on admission (13.5%), mainly in the nose (n=35, 81.4%). However, the hands were affected in more than half of the MRSA carriers (n=24, 55.8%). Risk factors for MRSA colonisation were atopic skin diathesis (OR 2.01, 95% CI 1.03 to 3.92, p=0.049) and presence of atopic dermatitis on other body parts than the hands (OR 4.33, 95% CI 2.23 to 8.43, p<0.001). Hand eczema was significantly more severe in MRSA carriers than in non-carriers (OR 1.23, 95% CI 1.10 to 1.37, p<0.001) and showed a higher prevalence of vesicles, erosions or fissures. MRSA eradication was successful in 67.4% after the first attempt.
  
  
  CONCLUSIONS
  Nurses with OSD have a twofold to threefold higher prevalence of MRSA colonisation than what has been reported for point-prevalence screenings among healthcare workers in Germany. Atopic skin diathesis, atopic dermatitis and severe hand eczema are the main risk factors. Thus, prevention and treatment of OSD could be important elements in reduction of colonisation with MRSA among nurses and transmission to others.
authors.affiliation: Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: Brans
authors.affiliation: Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kolomanski
authors.affiliation: Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Mentzel
authors.affiliation: Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Vollmer
authors.affiliation: Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Kaup
authors.affiliation: Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.
authors.forename: Swen Malte
authors.initials: SM
authors.lastname: John
mesh_terms: D000328:Adult; D000368:Aged; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D015169:Colony Count, Microbial; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000382:microbiology*; D004485:Eczema / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006225:Hand / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D008499:Medical Records; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D009726:Nurses; D009784:Occupational Diseases / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
keywords: MRSA; Staphylococcus aureus; nurses; occupational skin diseases