Fomite Transmission of Meticillin-Resistant Staphylococcus aureus in an Emergency Room Based on Real Touch Behaviors of Healthcare Workers and Patients

Meticillin-resistant Staphylococcus aureus (MRSA) is a significant cause of hospital-acquired infections (HAIs), posing a serious threat to healthcare workers (HCWs). All touching behavior data were from a clinical skills competition of a medical school in Hong Kong; more than 12,000 touches involving 3 patients (infusion, critically ill, and agitation) and 25 HCWs were collected. A fomite transmission model considering real touch behaviors was established to simulate the MRSA transmission in an emergency room, then the MRSA exposure risk of HCWs and effectiveness of interventions were analyzed. HCWs had a low touch frequency of facial mucous (doctors: 1.7 times/h; nurses: 1.1 times/h). The MRSA intake fractions for doctors were 2–4 times higher than those for nurses. Handwashing twice per hour could reduce the MRSA intake fraction by 7%. Effectiveness of disinfecting only the top 10 high-risk public surfaces was 83% to 98% of the efficiency when disinfecting all public surfaces. MRSA mainly transferred via hand contact contributed over 89% of pathogen transmission. Therefore, disinfecting public surfaces or replacing them with antimicrobial surfaces was not effective. The findings highlight the importance of prioritizing hand hygiene among HCWs and optimizing interventions to enhance infection-control protocols in emergency rooms. And this study provides scientific evidence for the development of precise interventions for MRSA prevention and control in hospital emergency rooms.