Methicillin-resistant Staphylococcus aureus transmission: Unrecognised patient MRSA carriage

Introduction: Even though methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of nosocomial infections, it may often be difficult to evaluate the exact route of transmission. Methods: In this study, we describe four cases of nosocomial transmission of MRSA in a hospital with a low MRSA incidence. Results: In one case, a multi-traumatic patient arrived from a hospital in a foreign country and the primary surveillance swaps were negative for MRSA. The second case was a child with burn wounds who was referred from a Danish hospital. The third case was a multi-traumatic patient from Denmark. The fourth case was a new-born child in the neonate unit. CONCLUSION: In none of the cases, the index patient was known to have MRSA on admission and no specific precautions were taken to prevent transmission. In all cases there was intensive contact between the patient and the staff which may increase the risk of contaminating hands, arms and the front of the uniform. Hand hygiene is therefore essential, but the use of protection gowns with long sleeves is also important in order to prevent transmission of MRSA. After culture of MRSA and implementation of specific precautions to prevent transmission of MRSA, no further transmissions were observed.