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Updated: May 13, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Impact of methicillin resistant Staphylococcus aureus contact isolation units on medical care
Vincent Masse1, Louis Valiquette, Soraya Boukhoudmi
1Infectious Diseases Division, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
Background:
Patient isolation using contact precautions has gained widespread use to halt MRSA transmission, however supportive data is scarce and concerns regarding patient safety and satisfaction have been raised. At our institution, MRSA patients are isolated on a dedicated ward (cohort isolation), rather than in separate rooms. Our objectives were (1) to determine the proportion of bedside medical visits to patients on an isolation ward, (2) to quantify complications in those patients and (3) to determine if those complications are related to isolation and if they can be prevented.
Methods:
This retrospective case-control study was performed on the two sites of a tertiary teaching hospital in Sherbrooke, QC, Canada. We matched MRSA patients with an admission diagnosis of heart failure or chronic obstructive pulmonary disease to similar non-isolated controls. The proportion of bedside visits was ascertained through the number of progress notes with subjective elements or with a physical examination. Complications were sought through an extensive file review, and events were analysed according to Baker's CAES causality and preventability scales.
Results:
Overall, 111 patient pairs were analysed (35 with heart failure and 76 with COPD). Isolated patients received less bedside visits (subjective notes/1,000 patient-days: 849.6 vs. 983.3, p = 0,001). Attending physicians (454.5 vs. 451.4, p = 0,02) and residents (347.0 vs. 416.9, p = 0.01) are responsible for this discrepancy, while medical students appear to visit isolated and non-isolated patients equally (116.5 vs. 114.9, p = 0.90). Isolated patients showed a tendency towards longer stay and more preventable complications, although no difference in the total number of complications was observed.
Conclusion:
Isolated patients have less documented care that suggests less bedside visits from the medical staff, which could hamper the therapeutical relationship. Further studies are needed to explain this finding.
Insights
Patient isolation for MRSA may reduce bedside medical visits, potentially impacting patient care and relationships. Further research is needed to understand these effects and ensure patient safety.
Area of Science:
- Infectious Disease Epidemiology
- Patient Safety Research
- Healthcare Quality Improvement
Background:
- Contact precautions for Methicillin-resistant Staphylococcus aureus (MRSA) are common but lack robust supporting data.
- Concerns exist regarding patient safety and satisfaction with isolation protocols.
- This study examines cohort isolation on a dedicated ward versus separate rooms.
Purpose of the Study:
- To determine the proportion of bedside medical visits for patients on an isolation ward.
- To quantify complications in isolated patients.
- To assess if complications are related to isolation and if they are preventable.
Main Methods:
- Retrospective case-control study at a tertiary teaching hospital.
- MRSA patients (heart failure, COPD) matched with non-isolated controls.
- Bedside visits assessed via progress notes; complications analyzed using causality and preventability scales.
Main Results:
- 111 patient pairs analyzed; isolated patients had fewer bedside visits (p=0.001).
- Discrepancy primarily due to attending physicians and residents, not medical students.
- Isolated patients showed a trend towards longer stays and more preventable complications.
Conclusions:
- Isolated patients receive less documented care, suggesting fewer bedside visits.
- This reduction in medical staff interaction may negatively affect the therapeutic relationship.
- Further investigation is required to elucidate the reasons and implications of reduced bedside visits.
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