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Impact of Discontinuing Contact Precautions for Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant

Gonzalo Bearman1, Salma Abbas1, Nadia Masroor2

  • 11Division of Infectious Diseases,Virginia Commonwealth University,Richmond,Virginia.

Infection Control and Hospital Epidemiology
|March 28, 2018
PubMed

Insights

Discontinuing contact precautions for patients with MRSA or VRE did not increase infections when combined with other prevention methods. This strategy is safe and cost-effective for managing these resistant bacteria.

Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Infection Prevention and Control

Background:

  • Healthcare-associated infections (HAIs) caused by multidrug-resistant organisms (MDROs) like methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) pose significant challenges.
  • Contact precautions are a standard but resource-intensive measure to prevent MDRO transmission.

Purpose of the Study:

  • To evaluate the impact of discontinuing contact precautions for MRSA and VRE on HAI rates.
  • To assess the safety and efficacy of this strategy in conjunction with other infection prevention interventions.

Main Methods:

  • A quasi-experimental, interrupted time series design was used at an 865-bed academic medical center from 2011 to 2016.
  • Seven horizontal infection prevention interventions were implemented, including discontinuation of contact precautions for MRSA/VRE in April 2013.
  • Segmented regression modeling analyzed changes in infection rates.

Main Results:

  • Overall HAI rates declined during the study period.
  • Following the discontinuation of contact precautions, infection rates for MRSA and VRE showed non-significant decreases.
  • Device-associated HAI rates also decreased without statistical significance.

Conclusions:

  • Discontinuing contact precautions for MRSA and VRE, when integrated with comprehensive horizontal infection prevention measures, was not associated with an increased incidence of device-associated infections.
  • This approach may offer a safe, cost-effective alternative for managing patients colonized or infected with MRSA and VRE.

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