Abstract
Medical residents may be at risk of becoming colonized by methicillin-resistant Staphylococcus aureus (MRSA) during their training. The occupational risk of this specific population is unknown. Furthermore, there are no data regarding MRSA colonization among health care professionals in Quebec. To determine the MRSA colonization rate in Laval University (Quebec City, Quebec) medical residents and compare it with the MRSA colonization rate of a control group. A controlled cross-sectional study of MRSA prevalence among medical residents of Laval University was performed. The control group consisted of Laval University undergraduate medical students without previous clinical rotations in their curriculum. After informed consent was obtained, participants were screened for MRSA with a nasal swab in both anterior nares. They also completed a questionnaire regarding relevant risk factors and demographic data. A total of 250 residents of all residency levels from medical and surgical specialties and 247 controls were recruited between February and April 2010. One case of MRSA colonization was detected among the residents and none in the control group (prevalence of 0.4% versus 0.0%; P=1.00). MRSA nasal carriage was very low among Laval University residents. This may reflect the decreasing rate of health care-associated MRSA in Quebec City. Young age and good health may also explain this low risk. The strict infection control policies for MRSA patients (including cohorting, use of gloves, gown and patient-dedicated equipment) may also contribute to prevent MRSA transmission. Medical residents in Quebec City appeared to be at very low risk of contracting MRSA through professional activities.
Highlights
BACkgRounD: Medical residents may be at risk of becoming colonized by methicillin-resistant Staphylococcus aureus (MRSA) during their training
The control group consisted of Laval University undergraduate medical students without previous clinical rotations in their curriculum
Pink colonies were confirmed as MRSA with a positive agglutination test (Staphaurex, Remel, USA), antibiotic susceptibility testing according to the Clinical and Laboratory Standards Institute standards (M02-A10) and penicillin binding protein 2A detection (PBP2′ test, Oxoid, Canada)
Summary
Data presented as n (%) unless otherwise indicated. IQR Interquartile range rhinitis, dermatitis, cystic fibrosis or other chronic condition, hospitalization within the previous three years, history of MRSA colonization or infection, and frequent visits to a sports centre. Pink colonies were confirmed as MRSA with a positive agglutination test (Staphaurex, Remel, USA), antibiotic susceptibility testing according to the Clinical and Laboratory Standards Institute standards (M02-A10) and penicillin binding protein 2A detection (PBP2′ test, Oxoid, Canada). Participation on a sports team and gym attendance (risk factors for community-acquired MRSA [CA-MRSA]) were more frequent in the control group. All other MRSA colonization risk factors were comparable between groups (Table 1). One case of MRSA colonization was detected in the residents group and none in the control group (prevalence of 0.4% versus 0.0%; P=1.00) (Table 2). DIsCussIon The main finding of the present study was that MRSA nasal carriage was very low among Laval University medical residents. The prevalence we found (0.4%) was comparable with the prevalence in the control group consisting of medical students not exposed to the hospital environment. MRSA acquisition did not appear to e40
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