The dynamic fomite transmission of Methicillin-resistant Staphylococcus aureus in hospitals and the possible improved intervention methods

Hospital-acquired Methicillin-resistant Staphylococcus aureus (MRSA) is a significant health concern worldwide. Surface cleaning and antimicrobial surfaces could be potentially important MRSA control measures in concert with hand hygiene, and more explorations are required on how to implement them efficiently. We developed a Markov chain model to simulate the dynamic transmission of MRSA among fomites in a general medical ward, and acquired the temporal and spatial patterns of MRSA distributions. In addition, we conducted network analyses to better understand the contact relationship between patients' hands and environmental surfaces. Furthermore, we investigated the effectiveness of applying different levels of the two interventions to seven types of surfaces, and utilized the MRSA distribution patterns and network analyses to account for the findings. Frequent surface cleaning and antimicrobial surfaces had larger impacts on MRSA exposures when applied to surfaces around the index and the adjacent patients and to public surfaces in the ward than when applied to surfaces around other susceptible patients in the ward. This study provides evidence for the effectiveness of the two intervention methods in reducing MRSA exposure, and contributes to the development of appropriate control measures for MRSA in hospitals.