MRSA is so prevalent in hospitals and institutions that if you swabbed the nose of every healthcare worker, almost all of us would be colonized with it. It is not transmitted through respiratory droplets, only by direct contact.
If you eliminated all healthcare workers with CMV or MRSA, you would have no healthcare workers left. And if you replaced us all with new ones, it wouldn't take long for the new folks to be colonized as well. Patients and healthcare workers trade germs back and forth. Being religious about handwashing, and using proper isolation procedures for people known to be colonized or infected, is the best we can do to control the spread of hospital-acquired infections.
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I thought so too, but went on medline and found enough articles like these to convince me otherwise:
Wilson RD, Huang SJ, McLean AS.
Department of Intensive Care Medicine, University of Sydney, Nepean Hospital, Penrith, New South Wales.
Air sampling directly onto a methicillin-resistant Staphylococcus aureus (MRSA) selective agar was performed at six locations three times weekly over a period of 32 weeks in a new, initially MRSA-free Intensive Care Unit to examine if MRSA is present in air sample cultures and, if so, whether it is affected by the number of MRSA colonized patients present. A total of 480 air samples were collected on 80 days. A total of 39/480 (8.1%) samples were found to be MRSA positive of which 24/160 (15%) positive air samples were from the single rooms, where MRSA colonised patients were isolated, and 15/320 (4.7%) were from the open bed areas. A significant correlation was found between the daily number of MRSA colonized or infected patients in the Unit and the daily number of MRSA positive air samples cultures obtained (r2=0.128; P<0.005). The frequency of positive cultures was significantly higher in the single rooms than in the open bed areas (relative risk=3.2; P<0.001). The results from one of the single rooms showed a strong correlation between the presence of MRSA patients and MRSA positive air samples (relative risk=11.4; P<0. 005). Our findings demonstrate that the presence of airborne MRSA in our unit is strongly related to the presence and number of MRSA colonized or infected patients in the Unit.
PMID: 15957717 [PubMed - indexed for MEDLINE]
Shiomori T, Miyamoto H, Makishima K.
Department of Otorhinolaryngology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu 807-8555, Japan.
OBJECTIVES: To quantitatively investigate the existence of airborne methicillin-resistant Staphylococcus aureus (MRSA) in a hospital environment and to perform phenotyping and genotyping of MRSA isolates to study MRSA epidemiology. DESIGN: Prospective surveillance of patients with MRSA infections or colonizations was performed, as was an observational study of environmental airAirborne samples were taken by an air sampler; samples were obtained from object surfaces by stamping or swabbing. Epidemiological study of MRSA isolates was performed with an antibiotic susceptibility test, coagulase typing, and pulsed-field gel electrophoresis. SETTING: Three single-patient rooms in a 37-bed otolaryngology-head and neck surgery unit. PATIENTS: Three patients with squamous cell head and neck cancer were observed to have been colonized or infected with MRSA after surgery. RESULTS: The MRSA samples were collected from the air in single-patient rooms during both a period of rest and when bedsheets were being changed. Isolates of MRSA were detected in all stages (from stage 1 [>7 microm] to stage 6 [0.65-1.1 microm]). About 20% of the MRSA particles were within a respirable range of less than 4 microm. Methicillin-resistant S aureus was also isolated from inanimate environments, such as sinks, floors, and bedsheets, in the rooms of the patients with MRSA infections as well as from the patients' hands. An epidemiological study demonstrated that clinical isolates of MRSA in our ward were of one origin and that the isolates from the air and from inanimate environments were identical to the MRSA strains that caused infection or colonization in the inpatients. CONCLUSIONS: Methicillin-resistant S aureus was recirculated among the patients, the air, and the inamimate environments, especially when there was movement in the rooms. Airborne MRSA may play a role in MRSA colonization in the nasal cavity or in respiratory tract MRSA infections. Measures should be taken to prevent the spread of airborne MRSA to control nosocomial MRSA infection in hospitals.
PMID: 11405862 [PubMed - indexed for MEDLINE]
I have a bad feeling we are going to wind up having to wear submicron masks (like breathing through a thick cushion) or respirators around MRSA positive patients.
Crypto6
Noone is being allowed off the plane......
