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Background  Environmental disinfection with continuously antimicrobial surfaces could offer superior control of surface bioburden. We sought to decide the efficacy of photocatalyst antimicrobial coating in reducing methicillin-resistant  Staphylococcus aureus  (MRSA) acquisition in high incidence setting.    Methods  We performed prospective cohort study involving patients hospitalized in medical intensive care unit. A titanium dioxide-based photocatalyst was coated on high touch surfaces and walls. Five months of pre-intervention data were compared with five months of post-intervention data. The incidence rates of multidrug-resistant organism acquisition and the rates of hospital-acquired blood stream infection, pneumonia, urinary tract infection, and  Clostridium difficile –associated diseases were compared using Cox proportional hazards regression analysis.    Results  In total, 621 patients were included. There was significant decrease in MRSA acquisition rate after photocatalyst coating (hazard ratio, 0.37; 95% confidence interval, 0.14–0.99;  p  = 0.04). However, clinical identification of vancomycin-resistant  Enterococcus spp.  and multidrug-resistant  Acinetobacter baumannii  did not decrease significantly. The hazard of contracting hospital-acquired pneumonia during the intervention period compared to baseline period was 0.46 (95% confidence interval, 0.23–0.94;  p  = 0.03).    Conclusions  In conclusion, MRSA rate was significantly reduced after photocatalyst coating. We provide evidence that photocatalyst disinfection can be an adjunctive measure to control MRSA acquisition in high-incidence settings.    Trial registration  ISRCTN Registry ( ISRCTN31972004 ). Registered retrospectively on November 19, 2018.    Electronic supplementary material  The online version of this article (10.1186/s12879-018-3555-1) contains supplementary material, which is available to authorized users.

bmc infectious diseases

Environmental disinfection with photocatalyst as an adjunctive measure to control transmission of methicillin-resistant Staphylococcus aureus: a prospective cohort study in a high-incidence setting