抗藥性金黃色葡萄球菌仍是引起術後的傷口感染的主要致病菌之一。在某一神經內科加護病房同時發生抗藥性金黃色葡萄球菌術後傷口感染。因此我們執行了前瞻性的醫療照護相關人員鼻腔帶菌以及醫院環境細菌污染的調查來釐清可能的傳播途徑。對抗藥性金黃色葡萄球菌而言，醫療照護相關人員鼻腔帶菌的比率比環境汙染的比率高(11.3% versus 0.6%,p<0.05)。醫療照護相關人員有參與直接照顧群聚感染病患的帶菌比例比沒有參與直接照顧的高(31.0% versus 3.8%, p<0.05)，而就職業別來看的話醫師帶菌比率比其他醫師外的醫療照護相關人員高(21.7% versus 8.3%, p<0.05)。藉由利用脈衝式電泳的親源分析來分析所有的陽性菌株，所有病患分離出感染菌株均能分別找出一致的醫療照護相關人員的鼻腔帶菌。範圍包括主刀醫師，住院醫師，麻醉科醫師，病房及開刀房護理人員和助手。且在歸屬在同一族群的病患多半由相同的醫療照護人員照護。醫療照護相關人員，尤其是有鼻腔內帶菌者有潛在的危險會助長院內的抗藥性金黃色葡萄球菌傳播。藉由此次的帶菌調查，我們有更令人信服的證據來推廣洗手運動以阻絕接觸感染的院內水平傳播。此外鼻腔帶菌的清除，尤其在感染率高的時期，也可以是一個除了洗手以外值得考慮的輔助措施。

Methicillin-resistant Staphylococcus aureus (MRSA) is the leading pathogen of postoperative wound infections. A series of cases of post-neurosurgical wound infection with MRSA were detected in 1 and half months. A prospective survey of carriage in health-care workers (HCWs) and environmental contamination was conducted. The rate of MRSA nasal carriage in HCWs was higher than the rate of environmental contamination (11.3% versus 0.6%, p < 0.05). HCWs who were directly in contact with the infected patients had higher carriage rates than others (31.0% versus 3.8%, p < 0.05), while doctors had the highest carriage rates among all professionals (21.7% versus 8.3%, p < 0.05). Clinical isolates from post-neurosurgical wounds belonged to 3 different clusters; however, all had genotypes identical to those obtained from HCWs with staphylococcal carriage, including neurosurgeons, resident doctors, nurses, anesthesiologists, and anesthesia assistants. HCWs have an important role in the intra-hospital transmission of MRSA. This study highlighted the importance of hand hygiene in preventing contact transmission. Importantly, decolonization of MRSA carriage can be considered as a method of adjuvant infection control for interrupting an ongoing MRSA spread.