title: Transmission via the face is one route of methicillin-resistant Staphylococcus aureus cross-infection within a hospital.
abstract: 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, patients' 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 patients' faces were also touched for care before and after the operation.
  
  
  CONCLUSIONS
  Our study reveals the possibility of MRSA being transmitted by way of patients' faces in a hospital.
authors.affiliation: Department of Laboratory Medicine, Shinshu University Hospital, Asahi 3-1-1, Matsumoto 390-8621, Japan.
authors.forename: Akane
authors.initials: A
authors.lastname: Kuramoto-Chikamatsu
authors.forename: Takayuki
authors.initials: T
authors.lastname: Honda
authors.forename: Takehisa
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Mayumi
authors.initials: M
authors.lastname: Shiohara
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kato
mesh_terms: D015373:Bacterial Typing Techniques; D002876:Chromosomes, Bacterial / Q000235:genetics; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D004269:DNA, Bacterial / Q000032:analysis; D016521:Electrophoresis, Gel, Pulsed-Field; D005145:Face / Q000382:microbiology*; D006785:Hospitals, University; D006801:Humans; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D013211:Staphylococcus aureus / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification
chemical_list: D004269:DNA, Bacterial