Related Experiment Video
Updated: Dec 23, 2025
Improved Enzyme Protection Assay to Study Staphylococcus aureus Internalization and Intracellular Efficacy of Antimicrobial Compounds
Published on: September 8, 2021
Can we reduce contact precautions days for methicillin-resistant Staphylococcus aureus and vancomycin resistant
Elizabeth Dilip Thottacherry1, Ali Hassoun2
1Department of Internal Medicine, University of Alabama at Birmingham, School of Medicine - Huntsville Regional Campus.
Background:
Patients with MRSA (methicillin-resistant Staphylococcus aureus) and VRE (vancomycin resistant Enterococcus) are placed under contact precautions according to the Center of Disease Control protocol. Contact precautions however increases patient isolation from Health Care Workers, increase overall hospital costs and may increase depression and anxiety. Our aim in this study was to observe the effects of shortening the number of days of contact precautions for patients infected with MRSA and VRE.
Method:
We observed patients as two cohorts (Pre-Pilot and Pilot) in one Medical Intensive Care Unit, one Surgical Intensive Care Unit & two medical floors during 2014-2015. In the Pre-pilot period contact precautions were kept throughout admission. In the Pilot period contact precautions were initially placed followed by universal gloving. Comparisons were made for MRSA and VRE infection rates. Total costs were estimated assuming the average cost of 1 gown was $26 per patient per day.
Results:
Mean isolation days were reduced from 11.9 days to 6.8 days for MRSA and 12.8 days to 8.4 days for VRE. There were 86 MRSA infections in the Pre-Pilot period and 73 MRSA infections during the Pilot period (p=0.052). Incidence of hospital acquired MRSA in the wards decreased from 15 to 7 cases and 6 to 2 cases in the Intensive Care Unit in both the Pilot and Pre-Pilot periods respectively. Cost reduced by $2476 and $17,336 per month for VRE and MRSA patients. Number of readmissions also decreased by 39% for MRSA and 50% for VRE.
Conclusions:
A reduction in contact precautions has reduced patient costs without affecting the rate of MRSA and VRE infection within a one-year period.
Insights
Shortening contact precautions for patients with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) reduced isolation time and hospital costs without increasing infection rates.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Patient Safety
Background:
- Contact precautions are standard for MRSA and VRE, but increase isolation, costs, and potential patient anxiety.
- Current protocols may lead to prolonged patient isolation and higher healthcare expenditures.
Purpose of the Study:
- To evaluate the impact of reducing the duration of contact precautions for MRSA and VRE patients.
- To assess changes in infection rates, hospital costs, and readmissions.
Main Methods:
- A comparative study of two cohorts (Pre-Pilot and Pilot) in intensive care and medical units.
- Contact precautions were maintained throughout admission in the Pre-Pilot phase and shortened with universal gloving in the Pilot phase.
- Infection rates, costs, and readmissions were compared between the two periods.
Main Results:
- Mean isolation days decreased significantly for both MRSA (11.9 to 6.8) and VRE (12.8 to 8.4).
- A trend towards reduced MRSA infections was observed (86 to 73, p=0.052), with notable decreases in hospital-acquired MRSA.
- Significant cost reductions were achieved ($2476/month for VRE, $17,336/month for MRSA), alongside decreased readmission rates (39% for MRSA, 50% for VRE).
Conclusions:
- Reducing the duration of contact precautions is feasible and cost-effective.
- Shortened contact precautions did not negatively impact MRSA and VRE infection rates within the study period.
Related Concept Videos
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...
01:25Transmission-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...
01:23Hand hygiene
Hand washing...
01:28Antimicrobial Effectiveness
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...