The Presence of Methicillin Resistant Staphylococcus aureus (MRSA) on Environmental Surfaces in Healthcare Facilities Pre- and Post-Cleaning

......................................................................................................................................iii ACKNOWLEDGEMENTS............................................................................................................... iv LIST OF TABLES............................................................................................................................. ix LIST OF FIGURES............................................................................................................................ x CHAPTER 1 BACKGROUND.......................................................................................................... 1 CHAPTER 2 INTRODUCTION........................................................................................................ 4 Emergence of Antimicrobial Resistant Bacteria.......................................................... 4 Methicillin Resistant Staphylococcus aureus (MRSA)................................................. 6 Epidemiology of MRSA.................................................................................................... 8 Impact of MRSA............................................................................................................. 11 MRSA in Long-Term Care Facilities ............................................................................ 14 Treatment of MRSA Infections.................................................................................... 14 Routes of Transmission................................................................................................ 15 Environmental Decontamination................................................................................ 17 MRSA on Environmental Surfaces .............................................................................. 18 Objectives....................................................................................................................... 23 Research Questions and Hypotheses......................................................................... 24 CHAPTER 3 MATERIALS AND METHODS................................................................................. 26 Experimental Design..................................................................................................... 26 Quality Control Organisms and Culture Media......................................................... 26 Sample Collection.......................................................................................................... 27 Sample Processing........................................................................................................ 28 DNA Extraction and Purification................................................................................. 30