Molecular Epidemiology of MRSA Among Patients and Employees in a Surgical Intensive Care Unit

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a pervasive drug resistant human pathogen and has become widespread in hospitals around the world. MRSA infections cause approximately 19,000 deaths among hospitalized Americans annually. It is one of the leading causes of healthcare associated, or nosocomial infections, particularly in intensive care units. Hospital acquired MRSA (HA-MRSA) has been a battle for inpatients since the 1960's. However, in the late 1990's, a new strain of MRSA emerged. It appeared outside of the hospital setting and has been termed, community associated MRSA (CA-MRSA). Presently, CA-MRSA has been found to be spreading into the healthcare system presenting a new obstacle for patients and hospitals to overcome. It has been suggested that employees play a role in transmission of MRSA to hospitalized patients. Since healthcare workers are at the interface between hospitals and the community, they may serve as a potential reservoir for spreading MRSA. However, there are a limited number of studies that investigate employee MRSA colonization and subsequent transmission to patients. This study seeks to provide molecular evidence supporting the likelihood that employees play a role in MRSA transmission to patients. Furthermore, with the implementation of a version of "search and destroy", an infection control strategy, we show how reductions of hospital-acquired infections are achieved using this method.