Transmission via the face is one route of methicillin-resistant Staphylococcus aureus cross-infection within a hospital

Background It is generally accepted that hospital personnel must not touch their faces, and indeed must not elevate their hands above the shoulder in the ward, because many bacteria including Staphylococcus aureus colonize the face. However, possible methicillin-resistant Staphylococcus aureus (MRSA) cross-infection by way of faces has not yet been properly examined. Methods One hundred and seventy-eight isolates from 159 inpatients from February 1999 to January 2000 were subjected to chromosomal DNA analysis by pulsed-field gel electrophoresis (PFGE). Results The 178 MRSA isolates were classified into 43 PFGE types. Cross-infection was more frequent in the Department of Neurology [average number of patients per PFGE pattern (n/PFGE) = 4.0] than in the other six nonsurgical departments (n/PFGE = 1.0-1.6), and more frequent in four surgical departments (n/PFGE = 2.0-4.5) than in the other eight (n/PFGE = 1.0-1.7). In neurology, patientsʹ faces were more often touched for examination of the cranial nerves than in the other departments. In the above four surgical departments, organs in the face were chiefly operated upon, and the patientsʹ faces were also touched for care before and after the operation. Conclusions Our study reveals the possibility of MRSA being transmitted by way of patientsʹ faces in a hospital.