The Role of Healthcare Workers with Methicillin-Resistant Staphylococcus aureus Carriage and their Association with Clinical Isolates from Post-neurosurgical Wound Infections

Methicillin-resistant Staphylococcus aureus (MRSA) is the leading pathogen of postoperative wound infections. A series of cases of post-neurosurgical wound infection with MRSA were detected in 1 and half months. A prospective survey of carriage in health-care workers (HCWs) and environmental contamination was conducted. The rate of MRSA nasal carriage in HCWs was higher than the rate of environmental contamination (11.3% versus 0.6%, p ＜ 0.05). HCWs who were directly in contact with the infected patients had higher carriage rates than others (31.0% versus 3.8%, p ＜ 0.05), while doctors had the highest carriage rates among all professionals (21.7% versus 8.3%, p ＜ 0.05). Clinical isolates from post-neurosurgical wounds belonged to 3 different clusters; however, all had genotypes identical to those obtained from HCWs with staphylococcal carriage, including neurosurgeons, resident doctors, nurses, anesthesiologists, and anesthesia assistants. HCWs have an important role in the intra-hospital transmission of MRSA. This study highlighted the importance of hand hygiene in preventing contact transmission. Importantly, decolonization of MRSA carriage can be considered as a method of adjuvant infection control for interrupting an ongoing MRSA spread.