Title |
Effectiveness of healthcare worker screening in hospital outbreaks with gram-negative pathogens: a systematic review
|
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Published in |
Antimicrobial Resistance & Infection Control, March 2018
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DOI | 10.1186/s13756-018-0330-4 |
Pubmed ID | |
Authors |
Nikos Ulrich, Petra Gastmeier, Ralf-Peter Vonberg |
Abstract |
Identifying the source of an outbreak is the most crucial aspect of any outbreak investigation. In this review, we address the frequently discussed question of whether (rectal) screening of health care workers (HCWs) should be carried out when dealing with outbreaks caused by gram negative bacteria (GNB).A systematic search of the medical literature was performed, including the Worldwide Outbreak Database and PubMed. Outbreaks got included if a HCW was the source of the outbreak and the causative pathogen was anEscherichia coli,Klebsiella spp.,Enterobacter spp.,Serratia spp.,Pseudomonas aeruginosa, orAcinetobacter baumannii.This was true for 25 articles in which there were 1196 (2.1%) outbreaks due to GNB, thereof 14 HCWs who were permanently colonized by the outbreak strain. Rectal screening of HCWs was helpful in only 2 of the 1196 (0.2%) outbreaks. Instead, the hands of HCWs served as a reservoir for the outbreak strain in at least 7 articles - especially when they suffered from onychomycosis or used artificial fingernails or rings. Due to very weak evidence, we do not recommend rectal screening of HCWs in an outbreak situation with GNB. However, besides a critical review of hand hygiene habits, it might be useful to examine the hands of staff carefully. This measure is cheap, quick to perform, and seems to be quite effective. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 4 | 24% |
United States | 2 | 12% |
Ireland | 2 | 12% |
Ukraine | 1 | 6% |
Venezuela, Bolivarian Republic of | 1 | 6% |
Unknown | 7 | 41% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 7 | 41% |
Members of the public | 6 | 35% |
Science communicators (journalists, bloggers, editors) | 2 | 12% |
Scientists | 2 | 12% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 63 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 8 | 13% |
Student > Ph. D. Student | 6 | 10% |
Student > Doctoral Student | 6 | 10% |
Student > Bachelor | 5 | 8% |
Student > Master | 5 | 8% |
Other | 12 | 19% |
Unknown | 21 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 15 | 24% |
Nursing and Health Professions | 5 | 8% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 5% |
Agricultural and Biological Sciences | 2 | 3% |
Biochemistry, Genetics and Molecular Biology | 2 | 3% |
Other | 11 | 17% |
Unknown | 25 | 40% |