title: A prospective study of the case-notes of MRSA-positive patients: a vehicle of MRSA spread.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) has received much publicity and remains a major problem for the health service. The aim of this study was to determine whether case-notes of MRSA-positive patients can act as a vehicle for MRSA transmission.
  
  
  METHODS
  A prospective study was performed of patients with active MRSA infection identified from a microbiology department database. Two swabs were taken from the cover of the case-notes and the page with the most recent entry for identification of MRSA using MRSA ID (Chromogenic agar medium), Pastorex and DNase tests. Positive case-notes were re-swabbed 96 h later.
  
  
  RESULTS
  A total of 50 MRSA-positive patients were identified from medical, surgical, high dependency and intensive care wards. Three sets of notes were MRSA positive (3/50; 6%). None of the positive case-notes was positive on re-swabbing at 96 h.
  
  
  CONCLUSIONS
  Case-notes of MRSA-positive patients can act as carriers of MRSA with the potential to spread MRSA to both healthcare and non-healthcare workers without direct contact with infected patients. We recommend extending the universal precautions to the handling of case-notes belonging to MRSA-infected patients.
authors.affiliation: Department of General Surgery, Royal Gwent Hospital, Newport, UK. nrri5@hotmail.com
authors.forename: N
authors.initials: N
authors.lastname: Hamza
authors.forename: G
authors.initials: G
authors.lastname: Bazoua
authors.forename: Y
authors.initials: Y
authors.lastname: Al-Shajerie
authors.forename: E
authors.initials: E
authors.lastname: Kubiak
authors.forename: P
authors.initials: P
authors.lastname: James
authors.forename: C
authors.initials: C
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000635:transmission*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D017053:Infection Control; D008297:Male; D008499:Medical Records; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000635:transmission*