Study Finds MRSA on Common Household Surfaces

AHRQ-funded researchers at the Washington University School of Medicine in St. Louis, Missouri, found methicillin-resistant Staphylococcus aureus (MRSA) on household surfaces in 46 percent of homes where children had a culture-positive active or recent community-associated MRSA infection. Researchers took samples from 50 households and found MRSA on commonly touched surfaces, most frequently on bed linens (18 percent), TV remote-control devices (16 percent), and bathroom hand towels (15 percent). There was also an association between MRSA contamination and more individuals present per 1,000-square-foot area. MRSA strains matching those infecting and colonizing household members were present on commonly handled surfaces, a factor that likely perpetuates MRSA transmission and recurrent disease. The study, “Contamination of Environmental Surfaces WithStaphylococcus aureus in Households With Children Infected With Methicillin-Resistant S. aureus,” was published online September 8 inJAMA Pediatrics.

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2014 Sep 8. doi: 10.1001/jamapediatrics.2014.1218. [Epub ahead of print]

Contamination of Environmental Surfaces With Staphylococcus aureus in Households With Children InfectedWith Methicillin-Resistant S aureus.

Fritz SA1, Hogan PG1, Singh LN1, Thompson RM1, Wallace MA2, Whitney K3, Al-Zubeidi D4, Burnham CA5, Fraser VJ6.

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Abstract

IMPORTANCE:

Household environmental surfaces may serve as vectors for the acquisition and spread of methicillin-resistant Staphylococcus aureus(MRSA) among household members, although few studies have evaluated which objects are important reservoirs of MRSA.

OBJECTIVES:

To determine the prevalence of environmental MRSA contamination in households of children with MRSA infection; define the molecular epidemiology of environmental, pet, and human MRSA strains within households; and identify factors associated with household MRSAcontamination.

DESIGN, SETTING, AND PARTICIPANTS:

Fifty children with active or recent culture-positive community-associated MRSA infection were enrolled from 2012 to 2013 at St Louis Children's Hospital and at community pediatric practices affiliated with the Washington University Pediatric and Adolescent Ambulatory Research Consortium in St Louis, Missouri.

MAIN OUTCOMES AND MEASURES:

Samples of participants' nares, axillae, and inguinal folds were cultured to detect S aureus colonization. Samples of 21 household environmental surfaces, as well as samples obtained from pet dogs and cats, were cultured. Molecular typing of S aureusstrains was performed by repetitive-sequence polymerase chain reaction to determine strain relatedness within households.

RESULTS:

Methicillin-resistant S aureus was recovered from samples of environmental surfaces in 23 of the 50 households (46%), most frequently from the participant's bed linens (18%), television remote control (16%), and bathroom hand towel (15%). It colonized 12% of dogs and 7% of cats. At least 1 surface was contaminated with a strain type matching the participant's isolate in 20 households (40%). Participants colonized with S aureushad a higher mean (SD) proportion of MRSA-contaminated surfaces (0.15 [0.17]) than noncolonized participants (0.03 [0.06]; mean difference, 0.12 [95% CI, 0.05-0.20]). A greater number of individuals per 1000 ft2 (93 m2) were also associated with a higher proportion of MRSA-contaminatedsurfaces (β = 0.34, P = .03). The frequency of cleaning household surfaces was not associated with S aureus environmental contamination.

CONCLUSIONS AND RELEVANCE:

Methicillin-resistant S aureus strains concordant with infecting and colonizing strains are present on commonly handled household surfaces, a factor that likely perpetuates MRSA transmission and recurrent disease. Future studies are needed to determine methods to eradicate environmental contamination and prevent MRSA transmission in households.