AJR: Rad department, mobile equipment may spread MRSA

As a high-volume traffic area that regularly encounters methicillin-resistant Staphylococcus aureus (MRSA)-positive patients, the radiology department needs to practice meticulous infection control measures to prevent the transmission of infectious organisms, according to a review published in the November issue of American Journal of Roentgenology.

MRSA has increased in prevalence and is associated with increased lengths of stay, costs and mortality, wrote Edwin Zhang, MD, of the department of radiology and diagnostic imaging at the University of Alberta, Canada, and Brent Burbridge, MD, from the medical imaging department at Royal University Hospital in Saskatoon, Canada.

The authors urged “immediate action” and outlined a multifaceted approach in the radiology department that adheres to infection control precautions and standards for environmental and equipment cleansing. Studies have suggested that a multifaceted approach to infection control can reduce MRSA transmission, they wrote.

Interventional radiologists should pay particularly close attention due to the potential for transmission during and after procedures. Zhang and Burbridge cited a survey noting that only 56 percent of interventional radiologists wore gowns, 50 percent wore caps and 54 percent used full barrier precautions during central line placement.

The authors referred to Centers for Disease Control and Prevention (CDC) guidelines for standard precautions, which include:

• Hand hygiene;
• Personal protective equipment (gloves, gown and mask, eye protection and face shield);
• Handling of soiled patient care equipment and textiles;
• Safe injection practices; and
• Environmental control.

Of particular importance to radiology, computers, personal digital and other IT devices should follow the environmental cleaning protocol. Potential transmission vectors in the radiology department also include portable imaging systems, radiology cassettes, keyboards and technologists. Previous studies detected infectious organisms on imaging devices in four hospitals consenting to an audit, according to the authors.

Education and monitoring, wrote Zhang and Burbridge, also play a key role. They suggested that healthcare providers adapt CDC hand hygiene policies to infection control measures. Recommended strategies included:

• An educational campaign and infection control training;
• Engineering controls;
• Administrative sanctioning and rewarding;
• Development of a climate promoting infection control and safety; and
• Avoiding overcrowding, understaffing and excessive workload.

Zhang and Burbridge concluded with a call for hospitals and administrators to practice and adhere to infection control guidelines to curb “the alarming trends in infection rates.”