1. Contillo, Christine RN
  2. Kayyali, Andrea MSN, RN
  3. Cutugno, Christine PhD, RN

Article Content

According to this study:


* No evidence shows a link between the incidence of patient contamination with MRSA in the ICU and inadequate hand hygiene among health care workers.


* Not a single case of MRSA transmission from either physicians or nurses to patients was identified, despite probable frequent exposure to the pathogen.



The issue of hospital-acquired infection of patients with increasingly virulent organisms has received much attention in recent months. It's believed that ICU patients are at highest risk for pathogenic contamination from the environment as well as from poor hand hygiene among providers.


Researchers evaluated the incidence of methicillin-resistant Staphylococcus aureus (MRSA) transmission from colonized or infected patients to the ICU environment and the subsequent transmission of the pathogen to uninfected patients at two teaching hospitals in London, England.


The researchers took 2,436 samples from environmental sites, including telephones, computer keyboards, door handles, medical charts, the undersides of chart tables, cardiac monitors, nurses' notes, and the tap handles of sinks. Also sampled were the pens, hands, and aprons of daytime nurses, as well as daytime physicians' hands and communal telephones. Samples weren't taken from other health care workers.


By the end of the study period, only one patient had acquired a strain of MRSA previously isolated from the environment. Five other patients had become colonized with strains not previously isolated from the environment. No instances of MRSA transmission from nurse or physician to patient were identified. Because only certain daytime workers were included in the study, further research is indicated.


The researchers conclude that, despite probable frequent contact exposure to MRSA, few ICU patients become either colonized or infected with it. Although the finding is intriguing, those of us who work to contain the spread of nosocomial infection in the ICU look toward further and irrefutable proof that pathogenic contamination from equipment or staff does not occur.


C. Cutugno


Wilson AP, et al. Crit Care Med 2007;35(10):2275-9.