Table 2 Studies reporting methicillin-resistant Staphylococcus aureus (MRSA) colonisation in healthcare workers (HCWs) in non-outbreak situations in Europe and The United States

Quality level: high

Baldwin 2009 [31]

2005-2006 (9 months)

Northern Ireland

563

Nurses, care and domestic assistants, kitchen and clerical staff; nursing home (n = 45)

Nose

On one day in each nursing home

43 (7.5)

Nurses 8.7

1:Y; 2:Y;

Care assistants 10.2

3:Y; 4:N;

Others 3.5

5:Y; 6:Y;

7:Y

Elie-Turenne 2010 [32]

2008 (4 weeks)

US, New York

256

Nurses/therapists, physicians, clerical staff, paramedics; hospital (emergency department (ED), ICU, pre-hospital emergency medical service (EMS)

Nose

Swabs taken between 5:00–11:00 to gain participation of staff who worked during night, day & mid-day shifts

17 (6.6)

Nurses/ther. 10.5

1:Y; 2:Y;

Physicians 3.8

3:N; 4:N;

Clerical 3.6

5:Y; 6:Y;

Paramedics 1.9

7:Y

ED 9.6

ICU 5.1

EMS 1.9

Eveillard 2004 [33]

1998-1999 (7 months)

France

965

Nursing, medical, laboratory, radiology, engineering and administrative staff; hospital (ICU, medical ward, LTCF-E)

Nose

ND

60 (6.2)

Nursing 9.6

1:Y; 2:Y;

Medical 6.3

3:Y; 4:N;

Lab./radio. 2.7

5:Y; 6:Y;

Engineering 2.0

7:Y

Admin. 0.8

LTCF-E 36.0

Medical ward 12.5

ICU 3.0

Jager 2010 [34]

2008 (4 months)

The Netherlands

266

Employees; medical microbiology laboratory (n = 5)

Nose, throat

Self-swabbing

1 (0.4)

1:Y; 2:Y;

3:Y; 4:N;

5:Y; 6:Y;

7:N

Johnston 2007 [35]

2004-2005 (6 months)

US, Baltimore

200

Nurses and physicians; hospital (medical ICU and inpatient HIV infection unit)

Nose

Once a month

4 (2.0)^c

1:Y; 2:N;

8 (4.0)^d

3:Y; 4:N;

5:Y; 6:Y;

7:Y

Suffoletto 2008 [36]

2006 (3 months)

US, Pittsburgh

255

Nurses, nursing assistants, radiology and respiratory technicians, physicians, clerical staff; hospital (n = 5 (emergency departments)

Nose

Swabs taken at the beginning of the shift

11 (4.3)

Nursing/medical

1:Y; 2:Y;

technicians 6.9

3:N; 4:N;

Physicians 0.0

5:Y; 6:Y;

Clerical 0.0

7:Y

Vos 2009 [37]

2000-2004 (4 years)^c

The Netherlands

13.195

HCWs involved in the care of MRSA positive patients; hospital (medical centre)

Nose, throat, skin lesions

Routine personnel screening

31 (0.2)^d

1:Y; 2:Y;

3:Y; 4:N;

5:Y; 6:Y;

7:N

Quality level: moderate

Amorim 2009 [38]

2003-2005 (26 months)

Portugal

126

HCWs (nurses, nurse aids, physician, administrative and technical staff); hospital (vascular surgery, endocrinology ward)

Nose

3 screening sessions per year

6 (4.8)^c

Nurses 8.9

1:Y; 2:N;

Nurse aids 4.4

3:Y; 4:N;

Physicians 2.5

5:Y; 6:Y;

Admin/techn 0.0

7:N

Becker 2013 [39]

ND

Germany

13

Nursing staff; LTCF-E (n = 2)

Nose

ND

1 (7.7)

1:Y; 2:N;

3:N; 4:N;

5:Y; 6:N;

7:N

Berthelot 2004 [40]

2000 (1 month)

France

333

Fellows, nursing and medical students; control group of HCWs; hospital

Nose

ND

14 (2.5)

Students 2.4

1:Y; 2:Y;

Control group 2.6

3:N; 4:N;

5:N; 6:N;

7:Y

Bisaga 2008 [41]

2006 (5 months)

US, Chicago

105

Nurses, physicians, technicians; hospital (emergency department)

Nose

Swabs taken during the shift at times convenient to the subjects

16 (15.0)

Nurses 17.0

1:Y; 2:N;

Physicians 8.0

3:N; 4:N;

Technicians 18.0

5:Y; 6:Y;

7:Y

Boisseau 2012 [42]

2010 (1 day)

France

152

Physicians, paramedical HCWs; attendees of a medical conference

Nose

ND

4 (2.4)

1:Y; 2:N;

3:N; 4:N;

5:Y; 6:Y;

7:N

Brady 2009 [43]

2008 (1 day)

United Kingdom

260

Surgical and non-surgical physicians (phys.); attendees of a medical conference (n = 2)

Nose

ND

6 (2.0)

Surgical phys. 4.8

1:Y; 2:Y;

Non-surgical phys. 0.6

3:N; 4:N;

5:N; 6:Y;

7:N

Edmundson 2011 [44]

2005-2008 (4 years)

Ireland

566

Nurses, doctors, radio-graphers, occupational therapists, porters, physiotherapists; hospital (orthopaedic unit)

Nose

Twice a year as far as possible

27 (4.8)^c

1:Y; 2:Y;

3:N; 4:N;

5:N; 6:Y;

7:N

Garcia Lozano 2012 [45]

2011 (1 month)

Spain

62

HCWs involved in treat-ment of MRSA-positive patients; hospital; (ICU in an institute of oncology)

Nose, pharynx

ND

1 (1.6)

1:Y; 2:N;

3:N; 4:N;

5:Y; 6:N;

7:N

Gruber 2013 [46]

2006-2007 (6 months)

Germany

64

Staff members; nursing home (n = 8), geriatric clinic (n = 2)

Nose, throat

ND

2 (3.1)

Nursing home 4.0

1:Y; 2:N;

Geriatric clinic 0.0

3:N; 4:N;

5:Y; 6:N;

7:N

Heudorf 2002 [47]

2000-2001 (6 months)

Germany

158

Staff members; nursing home and geriatric rehabilitation unit

Nose, throat

ND

1 (0.6)

1:Y; 2:N;

3:N; 4:N;

5:N; 6:N;

7:N

Ibarra 2008 [48]

2006-2007 (16 months)

US, South Texas

257

Nurses, physicians, other health care personnel; paediatric hospital

Nose

ND

30 (12.0)

Nurses 12.0

1:Y; 2:Y;

Physicians 13.0

3:N; 4:N;

Other HCWs 11.0

5:Y; 6:Y;

7:N

Kaminski 2007 [49]

2001-2002 (4 months)

Germany

324

Nurses and physicians involved in the treatment of MRSA-positive patients; hospital (trauma unit)

Nose, throat

ND

17 (5.3)

1:Y; 2:Y;

3:N; 4:N;

5:Y; 6:N;

7:N

Kampf 2003 [50]

1995-1996 (12 months)

Germany

447

Nursing and medical staff); hospital (ICU and general ward)

Nose, oro-pharynx

Episodal staff screening

3 (0.7)

Nursing 0.8

1:Y; 2:Y;

Medical 0.0

3:N; 4:N;

General ward 0.7

5:Y; 6:Y;

ICU 0.6

7:N

March 2010 [51]

2008 (1 month)

Italy

69

Nurses, physicians and other staff; LTCF-E (n = 5)

Nose, oro-pharynx, inguinum

ND

10 (14.5)

1:Y; 2:N;

3:Y; 4:N;

5:Y; 6:N;

7:N

Monaco 2009 [52]

2005 (2 days)

Italy

51

Staff members; nursing home

Nose

ND

3 (5.8)

1:Y; 2:N;

3:N; 4:N;

5:Y; 6:N;

7:N

Neuhaus 2002 [53]

2000-2001 (12 months)

Germany

193

Nursing staff; nursing home (n = 61)

Nose, throat

ND

1 (0.5)

1:Y; 2:N;

3:N; 4:N;

5:Y; 6:N;

7:Y

Nulens 2005 [54]

2003 (1 day)

United Kingdom

335

Physicians and non-physicians; attendees of a medical congress

Nose

Swabs taken by HCWs them-selves during the congress

1 (0.3)

Physicians 0.5

1:Y; 2:N;

Non-physicians 0.0

3:N; 4:N;

5:Y; 6:N;

7:N

Orsi 2008 [55]

ND

Italy

200

Nurses and physicians; hospital (general ward, ICU, cardio- and neurological surgery unit)

Nose

Swabs taken at the beginning of the shift

3 (1.5)

Nurses 1.6

1:Y; 2:N;

Physicians 1.3

3:N; 4:N;

5:N; 6:Y;

7:Y

Prior 2011 [56]

2003 [2003–2010]

Ireland

172^c [2.048]^d

Nurses, physicians, other staff; hospital (orthopaedic surgery unit)

Nose

Routine pre-employment screening

3 (1.7)^c [47 (2.3)]^d

1:Y; 2:Y;

3:N; 4:N;

5:N; 6:Y;

7:N

Reich-Schupke 2010 [57]

2008 (8 weeks)

Germany

83

Employees; hospital (dermatological ward)

Nose

Swabs taken before starting work

4 (4.8)

1:Y; 2:N;

3:N; 4:N;

5:Y; 6:Y;

7:N

Sassmannshausen 2011 [58]

2010 (ND)

Germany

726

HCWs (nurses, physicians, other staff); hospitals (n = 9)

Nose, pharynx

Swabs taken after a non-working weekend

33 (4.5) 23 (3.2%)^e

1:Y; 2:Y;

3:N; 4:N;

5:N; 6:N;

7:N

Scarnato 2003 [59]

2000 (12 months)

France

193

Nursing staff, physicians, physical therapists, office staff; geriatric wards (acute medical care and long-term care units)

Nose

Once a month

4 (2.1)^c

1:Y; 2:N;

3:N; 4:Y;

5:Y; 6:Y;

7:N

Schwarzkopf 2010 [60]

ND (12 months)

US, New York

135

Surgeons (resident and attending surgeons); hospital (orthopaedic surgery)

Nose

ND

2 (1.5)

Attending surgeons 2.7

1:Y; 2:N;

Resident surgeons 0.0

3:Y; 4:Y;

5:N; 6:N;

7:N

Stahl 2011 [61]

ND

France

565

Physicians (phys.); attendees of medical conferences in France

Nose

ND

29 (5.1)^f

Intensive care phys. 8.0

1:Y; 2:Y;

Infect. disease phys. 2.4

3:N; 4:N;

Hygiene phys. 1.6

5:Y; 6: N;

7:N