Effective Method of Lowering MRSA Carriage Rates on Surfaces in a Dental School–Based Oral & Maxillofacial Surgery Clinic

Purpose The purpose of this study was to test whether the placement of a standardized cleaning protocol in oral and maxillofacial surgery operatories could effectively reduce MRSA (methicillin-resistant Staphylococcus aureus) colonization rates on operatory surfaces. Methods Eight operatories were each swabbed at 6 different sites using a moist sterile swab (Amies gel with charcoal). The sites were right light handle, right armrest, headlight band, headlight bulb cover, handpiece buttons, pen from pen pad. Swabs were immediately transported to the microbiology lab and inoculated onto agar media, 3 plates/swab. MRSA colonizations were counted. Rooms were initially swabbed twice approximately 2 months apart, without prior notice being given (experiment 1 and experiment 2, respectively). Following the posting of room cleaning protocols, the rooms were reswabbed following a further 2-month period (post-Standard Operating Procedure). Results For those sites resulting in the isolation of MRSA, the total count for all 6 sites was 5 for experiments 1 and 2; hence, the RR (relative risk) for the comparison of experiments 1 and 2 was 1.00 (P = 1.000, 95% confidence interval, 0.27-3.72). In the post-SOP period, the total count was 0 for all 6 sites (Figure 1c); thus, the RR for the comparisons of experiment 1 and experiment 2 vs post-SOP was 0.0 (P = .031, 95% confidence interval, 0.00-0.82). Conclusion Posting a standardized cleaning protocol in oral and maxillofacial surgery operatories is a simple and effective way to reduce MRSA colonization on operatory surfaces. In our study, multiple colonies of MRSA were isolated from operatory surfaces in 2 independent samplings before the posting of a cleaning protocol, but no colonies were isolated after its posting. There are essentially no costs associated with placement of this protocol, and there are potentially tremendous savings to the patient and health care system if infections can be prevented by this method.