Even perfect hand hygiene can't halt MRSA spread to NICU babies

Even if healthcare workers wash their hands perfectly, they could still transmit methicillin-resistant Staphylococcus aureus to vulnerable infants in the neonatal intensive care unit, according to new research in Infection Control & Hospital Epidemiology.

Researchers from Drexel University created a simulated NICU at Newark, Del.-based Christiana Care to see the potential for per-hour infant-to-infant MRSA transmission via a healthcare worker resulting in colonization.

They varied starting MRSA colonization rates from 2 to 8 percent, and hand hygiene rates ranged from 0 percent (no hand hygiene) to 100 percent.

They found colonization was reduced by 86 percent when hand hygiene was at 100 percent, meaning "even under optimal hygiene conditions, horizontal transmission of MRSA is possible," the study concludes.

Neal Goldstein, PhD, the study's lead author, said, "The biggest implication is that hospitals should not just rely upon hand hygiene alone for protecting patients from becoming colonized and possibly infected with a difficult-to-treat organism. Rather, infection control is a multipronged strategy. It can incorporate early detection and measures to mitigate spread that include[s] possible decolonization or using an antibiotic to treat a patient even before infection."

Dr. Goldstein also suggested clinicians are not the only participants in infection control efforts.

"We can follow hygiene procedures, use gowns or gloves as needed, keep a clean environment, not bring in possible fomites such as cell phones, watches or jewelry, and be a watchdog for the hospital, requesting that healthcare workers do hand hygiene if we don't see it being done. Outside the hospital, patients and parents can be more vigilant in requesting and using antibiotics appropriately so as to not give rise to antimicrobial-resistant organisms," he said.

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