Contact precautions for methicillin-resistant Staphylococcus aureus colonization: costly and unnecessary?

Methicillin-resistant Staphylococcus aureus (MRSA) is frequently encountered in health care facilities. Many hospitals have established screening programs to identify individuals harboring the organism. Patients identified as carrying MRSA are frequently placed in Contact Precautions at time of admission.

Between January 1, 2007, and December 31, 2010, we screened a select group of patients for MRSA employing polymerase chain reaction testing. We recorded our screening results and also recorded the MRSA hospital-acquired infection (HAI) rate. In January 2010, we discontinued placing individuals, asymptomatically colonized with MRSA, in Contact Precautions.

Between January 1, 2007, and December 31, 2010, we screened 6,712 asymptomatic patients for MRSA and found 633 (9.4%) to be positive. During this same time period, we encountered 7 MRSA HAI. There was 1 MRSA HAI in the first year and 2 in each of the last 3 years of the study period. The costs incurred for Contact Precautions for the MRSA study population averaged $8,055 per year for each of the first 3 years and $0 for 2010.

Placing patients who are asymptomatically harboring MRSA in Contact Precautions did not decrease the rate of HAI caused by this organism and was relatively expensive.