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[Prevention of MRSA spread in the neurosurgical field]
M Fujii1, S Yasuhara, Y Ohmoto
1Department of Neurosurgery, University of Yamaguchi School of Medicine.
Abstract:
We investigated the distribution of MRSA (methicillin-resistant Staphylococcus aureus) on and around six patients with MRSA infection in our neurosurgical ward. All patients had a disturbance of consciousness and had sputum colonization of MRSA. Samples were obtained from 11 sites (patients' hands, attendances' hands, floors, sidetables, bedclothes, chairs, walls, curtains, door knobs, faucets and disposable gloves) in the patients' rooms by the wiping method. High counts of MRSA were detected on horizontal planes such as floors, sidetables and chairs, but MRSA was not detected on vertical planes such as curtains and walls. The reason why MRSA was detected on the horizontal planes was due to a fall of MRSA spread from sputum in the air. These findings indicate that the disinfection of horizontal planes is important for preventing the spread of MRSA. We also evaluated what disinfectant was useful for floor disinfection and concluded that 0.5% chlorhexidine digluconate (Hibitane) and 0.5% benzalkonium chloride (Osvan) were more effective than the other usually-used disinfectants such as alkyldiaminoethyl glycine (Tego-51).
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) primarily contaminates horizontal surfaces in neurosurgical wards due to airborne sputum. Disinfecting floors and tables is crucial for MRSA infection control.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Context:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings, particularly neurosurgical wards.
- Patients with altered consciousness and sputum colonization are potential sources of MRSA transmission.
Purpose:
- To map the distribution of MRSA on and around infected patients in a neurosurgical ward.
- To identify effective disinfectants for environmental MRSA decontamination.
Summary:
- MRSA was predominantly found on horizontal surfaces (floors, sidetables, chairs) in patient rooms, likely due to airborne spread from sputum.
- Vertical surfaces (walls, curtains) showed no MRSA detection.
- 0.5% chlorhexidine digluconate and 0.5% benzalkonium chloride were superior disinfectants for floors compared to others tested.
Impact:
- Highlights the importance of rigorous disinfection of horizontal surfaces to prevent MRSA spread in hospitals.
- Provides evidence-based recommendations for disinfectant selection in MRSA-prone environments.
- Informs infection control strategies in neurosurgical intensive care units.