Mapping the dynamic transmission of MRSA: lessons learnt from a pilot study

Lesley Price, Danielle McEwan, Susan Lang, Joanne Booth

Research output: Contribution to conferencePaper


The most common route of transmission of Staphylococcus aureus in hospital settings is thought to be direct person to person. However, the possibility exists that indirect transmission takes place, involving transfer of organisms between human sources (patient, visitor or staff) via environmental vectors. The aim was to pilot methods to investigate the indirect transmission of MRSA within the near-patient environment in acute hospital wards. The approach used was a prospective study involving direct structured observation of patient and visitor hand-touch activities combined with environmental surveillance of the near-patient area. Three 120 minute observation sessions per day, for two days, were completed for each of the five MRSA positive patients included in the pilot sample. Environmental screening was performed at the start and end of each observation period. Lessons learnt during the study included: Screening staff for MRSA was a more sensitive issue than anticipated; Observation of patients’ hand touch activity was acceptable to staff, visitors and patients; Video-recording hand-touch activity can be performed easily and unobtrusively;
Analysing and interpreting the observed behaviour was straightforward and reliable; Patient recruitment was adversely affected by many factors beyond the study design; Identifying the organisms in the near-patient environment was not challenging but being able to trace its transmission was. In conclusion, observation using video-recording was an effective and robust method for investigating the impact of patients’ and visitors’ hand touch activity on the transmission of MRSA within the near-patient area. However, the hand touch activity of staff is also required to be able to model the role of the near-patient environment in the dynamic transmission of MRSA.
Original languageEnglish
Publication statusUnpublished - 2012


  • MRSA
  • screening
  • Staphylococcus aureus
  • health care staff
  • hospital infection


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