A simple petri dish test revealed that by overlooking basic hygiene, a healthcare worker infected a quadriplegic Iraq war veteran with MRSA, an antibiotic-resistant bacteria that plagues hospitals.

The Cleveland VA medical center has an aggressive program to protect its patients from germs, and part of that effort includes regularly swabbing their noses to check for staph. In this case, the quadriplegic man had never tested positive before, so clearly something had gone wrong.

"All patients admitted to VA hospitals are screened to determine if they carry MRSA," says Curtis Donskey, the doctor in charge of infection control. "When carriers are identified, extra precautions are taken to decrease the likelihood that MRSA will be spread to other patients."

Donskey figured out who had been in contact with the patient. He asked a medical student to give the patient an exam, touch an agar plate, use some hand sanitizer, and then make another imprint on an identical dish.

Each batch of agar contained a little bit of cefoxitin, an antibiotic that should prevent any ordinary bacteria from growing on the plates.

After a little bit of incubation, the first plate (left) was covered in bright red colonies. It provided damming evidence that the infection can easily be spread by hand.

The second plate (right) was completely free of bacteria. It showed that disaster can be averted very easily. By taking just a minute to lather up, anyone who works with patients can fight the spread of antibiotic-resistant bugs.

"Healthcare workers usually clean their hands with alcohol because it is very effective at killing most of the bacteria that cause hospital infections," says Donskey. "The exception is Clostridium difficile which is not killed by alcohol; for patients with C. difficile infection it is recommended that healthcare workers wear gloves and wash their hands with soap and water.

Donskey submitted a photo of each plate to the New England Journal of Medicine.

Image: Courtesy of the New England Journal of Medicine

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