Even Perfectly Clean Hands Cause MRSA Transmission in NICU Babies

Researchers examined transmission from baby to baby and found that even clean hands can lead to Methicillin-resistant Staphylococcus aureus (MRSA) transmission.

Among babies in the neonatal intensive care unit (NICU) it was found that even perfectly clean hands can lead to a superbug transmission, reveals a new study.

Drexel University researcher Neal D. Goldstein and his team decided to look at how the complex patient care environment of an NICU may lead to Methicillin-resistant Staphylococcus aureus (MRSA) transmission.

Hawthorne Effect Hinders Accurate Hand Hygiene Observation
When healthcare providers know they are being watched, they are twice as likely to comply with hand hygiene guidelines.

‘Following hygienic procedures, using gowns or gloves as needed, keeping the environment clean can help improve hygiene levels in the neonatal intensive care unit (NICU).’

Focusing on hand hygiene, a top indicator of whether infections might spread in hospitals, the researchers examined transmission from baby to baby, with the hospital workers that come into contact with newborns standing as the link. And as it turns out, even theoretically perfect compliance with hand hygiene won't completely eliminate the chance for MRSA to spread: the averaged risk reduction was 86 percent.

Goldstein said that the biggest implication is that hospitals should not just rely upon hand hygiene alone for protecting patients from becoming colonized 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 decolonization or using an antibiotic to treat a patient even before infection.

The study used MRSA, a difficult to treat pathogen that can be deadly for people with weak or underdeveloped immune systems, as its subject. Goldstein discovered that even if health workers had absolutely perfect hand hygiene, just under one in every 100 contacts between a baby and a hospital worker could still result in a MRSA transmission.

Magnified Images of Bacteria Boost Hand Hygiene Compliance
Health care workers practice improper hand hygiene and might need to clean their hands as many as 100 times per 12-hour shift.

During the average nine day stay, an infant is likely to have about 250 contacts with NICU workers that carry risk for MRSA transmission. While each contact is an opportunity for hygiene compliance, it is also potential for hygienic practices to break down.

"This sheds light on just how complex the patient care environment of a NICU is," Goldstein said. "There are so many opportunities to potentially pass an organism between healthcare workers and their patients."

Paper Towels Better Than Electric Dryers for Hand Hygiene
A new study has indicated that paper towels might be a better option for hand hygiene than electric dryers.

Although it seemed that MRSA could not be completely wiped out through perfect hand hygiene, the study did show that the better hand hygiene was, the more it cut down on the spread of MRSA. The effect never quite levelled off, but continued to get better as hygiene levels improved.

"We can follow hygiene procedures, use gowns or gloves as needed, keep a clean environment, not bring in possible fomites such as cell phones, watches, or jewellery, and be a watchdog for the hospital, requesting that healthcare workers do hand hygiene if we don't see it being done," Goldstein said.

Healthcare Workers Follow Hand Hygiene Recommendations in Presence of Colleagues
Healthcare workers were more likely to follow hand hygiene rules when other workers are nearby.

"Outside the hospital, patients and parents can be more vigilant in requesting and using antibiotics appropriately so as not to give rise to antimicrobial resistant organisms. We're all participants in infection control, not just the clinicians." The study is published in Infection Control & Hospital Epidemiology.

Source-ANI