To the Editor: Johnson et al detailed an intensive hand hygiene program planned to reduce the burden of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections.1 The results were based on observations before and after the program. Hand hygiene compliance rates reached only 42% despite the program, and there was no effect on patient MRSA colonisation or environmental colonisation or contamination. Outside the intensive care unit, there was no effect on health care worker colonisation. Despite this evidence of ineffectiveness, the program was held responsible for a reduction in hospital-wide rates of clinically important MRSA infections.
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