Environmental study of a methicillin-resistant Staphylococcus aureus epidemic in a burn unit

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Abstract
During an outbreak of infections caused by methicillin-resistant (MR) S. aureus in a burn unit, an extensive 10 wk study was conducted to define the environmental epidemiology of the organism. The inanimate environment in patient rooms and adjacent areas was examined using volumetric air samplers and Rodac plates. Airborne and surface level contamination with MR S. aureus was quantitated; MR S. aureus comprised 16, 31 and 40% of all bacterial growth from air, elevated surfaces and floor surfaces, respectively. Mean air, elevated surface and floor surface MR S. aureus contamination in rooms of MR S. aureus-infected burn patients were 1.9 MR S. aureus/ft3 (.apprx. 0.028 m3), 20 MR S. aureus/Rodac plate and 48 MR S. aureus/Rodac plate, respectively. Peak patient room environmental contamination levels were 6.9 MR S. aureus/ft3 of air, 70 MR S. aureus/Rodac plate per elevated surface and 138 MR S. aureus/Rodac plate per floor surface. Environmental contamination levels in the adjacent work areas were considerably lower than in infected patient rooms. There was ample opportunity for contamination of personnel through the inanimate environment in this unit.