Abstract
BackgroundsStaff in the hospital itself may be the source of a nosocomial outbreak (NO). But the role of undetected carriers as an outbreak source is yet unknown.MethodsA systematic review was conducted to evaluate outbreaks caused by health care workers (HCW). The Worldwide Outbreak Database and PubMed served as primary sources of data. Articles in English, German or French were included. Other reviews were excluded. There were no restrictions with respect to the date of publication.Data on setting, pathogens, route of transmission, and characteristics of the HCW was retrieved. Data from large outbreaks were compared to smaller outbreaks.Results152 outbreaks were included, mainly from surgery, neonatology, and gynecology departments. Most frequent corresponding infections were surgical site infections, infection by hepatitis B virus, and septicemia. Hepatitis B virus (27 NO), S. aureus (49 NO) and S. pyogenes (19 NO) were the predominant pathogens involved. 59 outbreaks (41.5%) derived from physicians and 56 outbreaks (39.4%) derived from nurses. Transmission mainly occurred via direct contact. Surgical and pediatric departments were significantly associated with smaller outbreaks, and gynecology with larger outbreaks. Awareness of carrier status significantly decreased the risk of causing large outbreaks.ConclusionsAs NO caused by HCW represent a rare event, screening of personnel should not be performed regularly. However, if certain species of microorganisms are involved, the possibility of a carrier should be taken into account.
Highlights
Healthcare associated infections (HCAI) are infections that are acquired as a result of healthcare interventions
The PubMed search (609 hits) came up with 5 more nosocomial outbreak (NO) reports. 31 additional reports were found via the search of reference lists
This systematic review is based on overall 152 NO descriptions caused by health care worker (HCW) (Figure 1)
Summary
Healthcare associated infections (HCAI) are infections that are acquired as a result of healthcare interventions. Epidemics of HCAI may take place and are than called a nosocomial outbreak (NO). NO always represent extremely frightening incidents, but may still affect any medical department at any time in principle. Once a NO has been recognized as such, an outbreak investigation is usually initiated in order to discover its source. The outbreak’s source may get traced to a particular single health care worker (HCW) in some of the cases. If a HCW, happens to be the most likely or proven cause of pathogen spread to patients and nosocomial
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