Perfect hand hygiene ‘can still lead to MRSA transmission in NICU babies’

Perfectly clean hands can still lead to transmission of MRSA among babies in the neonatal intensive care unit (NICU), according to research led by Drexel University, US.

Dr Neal Goldstein, assistant research professor in the Dornsife School of Public Health, and his colleagues examined how a NICU environment, with its complex patient care, could potentially lead to MRSA transmission.

The researchers focused on hand hygiene, which is a main indicator of whether infections might spread in hospitals. They examined transmission from baby to baby, with the hospital workers that come into contact with newborns being the link.

They discovered that even theoretically perfect compliance with hand hygiene does not completely eliminate the opportunity for the bacterium to spread. They found that the average risk reduction was 86 per cent.

Dr Goldstein said: "The biggest implication is that hospitals should not just rely upon hand hygiene alone for protecting patients from becoming colonised and possibility infected with a difficult-to-treat organism.

“Rather, infection control is a multi-pronged strategy. It can incorporate early detection and measures to mitigate spread that include possible decolonisation or using an antibiotic to treat a patient even before infection."

Explaining his team’s choice to focus on MRSA, Dr Goldstein said they wanted to examine an organism that is frequently encountered in hospital environments. He said that in the NICU, MRSA is of particular importance as roughly one-third of babies that are colonised will go on to develop an invasive infection.

In a simulation study, Dr Goldstein discovered that even if health workers had absolutely perfect hand hygiene, almost one in every 100 contacts between a baby and a hospital worker could still result in MRSA transmission.

During an average nine-day stay, a baby is likely to have approximately 250 contacts with NICU workers.ADNFCR-2094-ID-801837433-ADNFCR