Date of Conferral

2016

Degree

Ph.D.

School

Public Health

Advisor

Raymond Panas

Abstract

Chiropractic training involves many hours of skin contact, and chiropractors have manual contact with millions of patients annually, but chiropractic has only had professional clinical hygiene guidance since 2010. Methicillin-resistant Staphylococcus aureus (MRSA) is the most common cause of cultured skin and soft tissue infection (SSTI) in the United States. Using the epidemiologic triad of person, place, and time as a framework, this quantitative, cross-sectional study obtained the first assessment of MRSA SSTI incidence among chiropractic students and its association with infection control behaviors (hand and table hygiene, sharing gowns, and sharing lotion) and initiation of patient care. The study obtained surveys from 312 students attending half (9/18) of U.S. chiropractic campuses. Associations were assessed by Ï?2 and Fisher's exact test. Stratum specific effects were assessed. Two logistic regression models were produced. The results were that attendance at Campus 6 was associated with postmatriculation MRSA SSTI in univariate analysis, p = 0.010. There was an interaction between campus attended, sharing lotion, and postmatriculation MRSA SSTI, with the Mantel-Haenszel pooled estimate varying significantly from unity, Ï?2 (1) = 6.75, p = 0.009. No other association between any assessed factor and MRSA SSTI was detected. Logistic regression models were significant (p < 0.05), but the composing variables were not. For social change, chiropractic colleges should instruct students and chiropractic associations could encourage members not to share massage lotions and emollients during the practice of manual therapy to help prevent MRSA SSTI.

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