Journal Article

Hospital Hygiene Paradox: MRSA and Enterobacteriaceae Colonization Among Cleaning Staff in a Tertiary Hospital in Saudi Arabia

Alqurashi, Maher S., Sawan, Asma A., Al Shubbar, Mohammed D., Huldar, Ammar S., El-Badry, Ayman A., Hunasemarada, Basavaraja C., Berekaa, Mahmoud M., Alamro, Saud A., Bojabara, Loay M., Al Qunais, Abdulaziz A.

2025

Overview

Background and Objectives: Despite extensive research on the sources and transmission pathways of Hospital-Acquired Infections (HAIs), the role of cleaning staff as potential vectors has been under-explored. This study addresses the gap by examining the cleaning staff’s role in nosocomial infection transmission, focusing on pathogenic bacteria and fungi colonization. Identifying potential pathogens harbored by cleaning staff that carry the risk of causing HAIs, especially methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae. Materials and Methods: This current cross-sectional study was conducted on 96 cleaning staff at King Fahad Hospital of the University and Family and Community Medicine-Centre, Eastern Province, Saudi Arabia. Sample collection targeted hands and nostrils using cotton swabs, followed by laboratory testing, including MALDI-TOF mass spectrometry for bacterial identification, and the cefoxitin disc diffusion test for the screening of MRSA. Results: In total, the occurrence of MRSA colonization was 9.4% while Enterobacteriaceae colonization was 15.6%. No significant correlation was found for MRSA among departments or between day and night shifts. Alternatively, individuals working in the ICU and the operating room showed higher chances of being colonized by Enterobacteriaceae, and a notable connection was identified between Enterobacteriaceae and day shifts. Ultimately, the frequency of handwashing reduced the chances of being colonized by MRSA and Enterobacteriaceae, underscoring the significance of good hygiene practices. Conclusions: The study highlights the potential role of cleaning staff in transmitting HAIs, indicating a need for further research and consideration of enhanced hygiene protocols in hospital settings.

• Publisher: MDPI AG,MDPI
• Subject: Adult / Antifungal agents / Antimicrobial agents / Bacteria / Cross Infection - epidemiology / Cross Infection - microbiology / Cross Infection - prevention & control / Cross-Sectional Studies / Disease control / Disease transmission / Drug resistance / Emergency medical care / Enterobacteriaceae / Enterobacteriaceae - isolation & purification / Enterobacteriaceae - pathogenicity / Enterobacteriaceae Infections - epidemiology / Female / Gram-negative bacteria / Gram-positive bacteria / Health aspects / hospital cleaning staff / hospital hygiene / hospital-acquired infections (HAIs) / Hospitals / Humans / Hygiene / Hygiene - standards / Infection / Intensive care / Male / Medicine / Methicillin / methicillin-resistant Staphylococcus aureus (MRSA) / Methicillin-Resistant Staphylococcus aureus - isolation & purification / Methicillin-Resistant Staphylococcus aureus - pathogenicity / Middle Aged / Morbidity / Mortality / Nose / Nosocomial infections / Outpatient care facilities / Pathogens / Patients / Saudi Arabia - epidemiology / Sociodemographics / Staphylococcus aureus / Staphylococcus aureus infections / Staphylococcus infections / Statistical analysis / Tertiary Care Centers - organization & administration / Tertiary Care Centers - statistics & numerical data