Mrsa Hands
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The
n e w e ng l a n d j o u r na l
of
m e dic i n e
images in clinical medicine
The Hands Give It Away A
B
A
24-year-old man who had quadriplegia due to a traumatic spi- Curtis J. Donskey, M.D. RETAKE 1st AUTHOR Donskey ICM Brittany C. Eckstein, B.S. nal cord injury was found on routine surveillance cultures to have methicil2nd REG F FIGURE a&b 3rd lin-resistant Staphylococcus aureusCASE (MRSA) nares. TITLEcolonization of his anterior Revised Cleveland Veterans Affairs Medical Center EMail Linethe potential 4-C He had no history of MRSA infection or colonization. To assess implica- Cleveland, OH 44106 SIZE Enon ARTIST: mst tions of the patient’s MRSA carriage for FILL infection control, anH/T imprintH/T of a health 39p6 care Combo worker’s ungloved hand was obtained for culture after the worker had performed an AUTHOR, PLEASE NOTE: Figure has been redrawn and type has beenthis reset. handabdominal examination of the patient. The MRSA colonies grown from check carefully. print on the plate (CHROMagar Staph aureus), whichPlease contained 6 μg of cefoxitin per milliliter to inhibit methicillin-susceptible S. aureus, are pink and show 1-15-09 the outline JOB: 36003 ISSUE: of the worker’s fingers and thumb (Panel A). With the use of a polymerase-chainreaction assay, the mecA gene, which confers methicillin resistance, was amplified from nares and imprint isolates. After the worker’s hand had been cleaned with alcohol foam, another hand imprint was obtained, and the resulting culture was negative for MRSA (Panel B). These images illustrate the critical importance of hand hygiene in caring for patients, including those not known to carry antibiotic-resistant pathogens. Copyright © 2009 Massachusetts Medical Society.
n engl j med 360;3 nejm.org january 15, 2009
Downloaded from www.nejm.org by PETER B. CRIDGE MD on March 8, 2009 . Copyright © 2009 Massachusetts Medical Society. All rights reserved.
e3
n e w e ng l a n d j o u r na l
of
m e dic i n e
images in clinical medicine
The Hands Give It Away A
B
A
24-year-old man who had quadriplegia due to a traumatic spi- Curtis J. Donskey, M.D. RETAKE 1st AUTHOR Donskey ICM Brittany C. Eckstein, B.S. nal cord injury was found on routine surveillance cultures to have methicil2nd REG F FIGURE a&b 3rd lin-resistant Staphylococcus aureusCASE (MRSA) nares. TITLEcolonization of his anterior Revised Cleveland Veterans Affairs Medical Center EMail Linethe potential 4-C He had no history of MRSA infection or colonization. To assess implica- Cleveland, OH 44106 SIZE Enon ARTIST: mst tions of the patient’s MRSA carriage for FILL infection control, anH/T imprintH/T of a health 39p6 care Combo worker’s ungloved hand was obtained for culture after the worker had performed an AUTHOR, PLEASE NOTE: Figure has been redrawn and type has beenthis reset. handabdominal examination of the patient. The MRSA colonies grown from check carefully. print on the plate (CHROMagar Staph aureus), whichPlease contained 6 μg of cefoxitin per milliliter to inhibit methicillin-susceptible S. aureus, are pink and show 1-15-09 the outline JOB: 36003 ISSUE: of the worker’s fingers and thumb (Panel A). With the use of a polymerase-chainreaction assay, the mecA gene, which confers methicillin resistance, was amplified from nares and imprint isolates. After the worker’s hand had been cleaned with alcohol foam, another hand imprint was obtained, and the resulting culture was negative for MRSA (Panel B). These images illustrate the critical importance of hand hygiene in caring for patients, including those not known to carry antibiotic-resistant pathogens. Copyright © 2009 Massachusetts Medical Society.
n engl j med 360;3 nejm.org january 15, 2009
Downloaded from www.nejm.org by PETER B. CRIDGE MD on March 8, 2009 . Copyright © 2009 Massachusetts Medical Society. All rights reserved.
e3
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