Related Experiment Video
Updated: Apr 7, 2026
Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
Published on: May 8, 2013
Reconsidering contact precautions for endemic methicillin-resistant Staphylococcus aureus and vancomycin-resistant
Daniel J Morgan1, Rekha Murthy2, L Silvia Munoz-Price3
11University of Maryland,Baltimore,Maryland.
Background:
Whether contact precautions (CP) are required to control the endemic transmission of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) in acute care hospitals is controversial in light of improvements in hand hygiene, MRSA decolonization, environmental cleaning and disinfection, fomite elimination, and chlorhexidine bathing.
Objective:
To provide a framework for decision making around use of CP for endemic MRSA and VRE based on a summary of evidence related to use of CP, including impact on patients and patient care processes, and current practices in use of CP for MRSA and VRE in US hospitals.
Design:
A literature review, a survey of Society for Healthcare Epidemiology of America Research Network members on use of CP, and a detailed examination of the experience of a convenience sample of hospitals not using CP for MRSA or VRE.
Participants:
Hospital epidemiologists and infection prevention experts.
Results:
No high quality data support or reject use of CP for endemic MRSA or VRE. Our survey found more than 90% of responding hospitals currently use CP for MRSA and VRE, but approximately 60% are interested in using CP in a different manner. More than 30 US hospitals do not use CP for control of endemic MRSA or VRE.
Conclusions:
Higher quality research on the benefits and harms of CP in the control of endemic MRSA and VRE is needed. Until more definitive data are available, the use of CP for endemic MRSA or VRE in acute care hospitals should be guided by local needs and resources.
Insights
The use of contact precautions (CP) for endemic methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) in hospitals lacks high-quality evidence. Local needs and resources should guide decisions on CP implementation.
Area of Science:
- Infectious Disease Epidemiology
- Hospital Infection Prevention
- Antimicrobial Resistance Control
Background:
- The necessity of contact precautions (CP) for controlling endemic methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) in acute care settings remains debated.
- Advances in hand hygiene, decolonization, environmental cleaning, and disinfection challenge traditional CP protocols.
Purpose of the Study:
- To develop a decision-making framework for CP use against endemic MRSA and VRE.
- To review evidence on CP's impact on patients and care processes.
- To assess current CP practices in US hospitals.
Main Methods:
- A comprehensive literature review was conducted.
- A survey of Society for Healthcare Epidemiology of America Research Network members assessed CP usage.
- The experiences of hospitals not employing CP for MRSA/VRE were examined.
Main Results:
- No high-quality data definitively support or refute the use of CP for endemic MRSA or VRE.
- Over 90% of surveyed hospitals utilize CP for MRSA and VRE, with 60% considering alternative approaches.
- More than 30 US hospitals do not use CP for endemic MRSA or VRE control.
Conclusions:
- Further high-quality research is essential to evaluate the benefits and risks of CP for endemic MRSA and VRE.
- In the interim, acute care hospitals should base CP decisions for MRSA and VRE on local requirements and available resources.
Related Concept Videos
01:25Clinical Significance of Antibiotic Resistance
01:17Transmission-based Precautions I: Contact, Enteric, and Droplets
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
01:26Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
01:23Hand hygiene
Hand washing...
01:25Mechanism of Antibiotic Resistance in MRSA
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...