The primary route of transmission for MRSA in hospitals is direct contact with infected surfaces or people. MRSA colonizes the skin and mucous membranes, making it easily transferable through touch. Healthcare workers' hands and contaminated medical equipment are common sources, leading to cross-contamination between patients. Unlike airborne pathogens, MRSA does not spread efficiently through droplets or air. Therefore, strict hand hygiene and environmental cleaning are critical to prevent its transmission in healthcare settings.

Reference: Principles of Infectious Diseases, Mandell, Douglas, and Bennett, 9th Edition.