The Impact of Discontinuing Contact Precautions for VRE and MRSA on Device-Associated Infections

Area of Science:

• Infectious Diseases
• Hospital Epidemiology
• Public Health

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant Enterococcus (VRE) are significant causes of hospital-acquired infections.
• Contact precautions are a standard infection control measure for patients colonized or infected with multidrug-resistant organisms.
• The necessity and impact of contact precautions for MRSA and VRE are debated, especially within robust infection prevention environments.

Purpose of the Study:

• To investigate the effect of discontinuing contact precautions for patients with MRSA and VRE colonization/infection on device-associated hospital-acquired infection (HAIs) rates.
• To evaluate the role of a strong horizontal infection prevention platform in mitigating potential increases in HAIs after policy changes.

Main Methods:

• A before-and-after study design was employed at an academic medical center.
• Data on device-associated HAIs were collected and analyzed for a period before and after the discontinuation of contact precautions for MRSA and VRE.
• The study controlled for the presence of a strong horizontal infection prevention platform.

Main Results:

• Discontinuation of contact precautions for patients with MRSA and VRE colonization/infection did not lead to an increase in device-associated HAIs.
• The rates of hospital-acquired infections remained stable despite the change in isolation policy.

Conclusions:

• In settings with a strong horizontal infection prevention infrastructure, discontinuing contact precautions for MRSA and VRE does not adversely affect device-associated HAI rates.
• This suggests that comprehensive infection control strategies may be more critical than universal contact precautions for these specific pathogens.