Related Experiment Video
Updated: Jul 6, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Discontinuation of Contact Precautions for Methicillin-resistant Staphylococcus aureus in a Pediatric Healthcare
Zachary M Most1,2, Bethany Phillips2, Michael E Sebert1,2
1Division of Infectious Disease, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Background:
Many hospitals caring for adult patients have discontinued the requirement for contact precautions (CP) for patients with methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization without reported negative effects. It is not clear whether this experience can be extrapolated to pediatric facilities.
Methods:
CP for MRSA were discontinued in all locations except the neonatal intensive care unit at a 3-hospital pediatric healthcare system in September 2019. All hospitalized patients underwent surveillance for LabID healthcare facility-onset MRSA infections. Analysis was done using interrupted time series (ITS) from September 2017 through August 2023 and aggregate before-and-after rate ratios.
Results:
There were 234 incident healthcare facility-onset MRSA infections during 766 020 patient days of surveillance. After discontinuation of CP for MRSA there was no change in the ITS slope (0.06, 95% CI: -0.35 to 0.47, P = .78) or intercept (0.21, 95% CI: -0.36 to 0.78, P = .47) of the LabID healthcare facility-onset MRSA infection incidence density rate. Additionally, there was no change in the aggregate incidence density rate of these MRSA LabID events (aggregate rate ratio = 0.98, 95% CI: 0.74 to 1.28). MRSA nasal colonization among patients being screened before cardiac surgery did not change (aggregate rate ratio = 0.94, 95% CI: 0.60 to 1.48). The prevalence rate of contact isolation days decreased by 14.0%.
Conclusions:
Discontinuation of CP for pediatric patients with MRSA was not associated with increased MRSA infection over 4 years. Our experience supports considering discontinuation of CP for MRSA in similar pediatric healthcare settings in the context of good adherence to horizontal infection prevention measures.
Insights
Contact precautions (CP) for methicillin-resistant Staphylococcus aureus (MRSA) were discontinued in a pediatric healthcare system. This change did not lead to an increase in MRSA infections, supporting similar practices in other pediatric facilities.
Area of Science:
- Infectious Diseases
- Pediatric Healthcare
- Hospital Epidemiology
Background:
- Many adult hospitals have stopped contact precautions (CP) for methicillin-resistant Staphylococcus aureus (MRSA) without adverse events.
- The applicability of these changes to pediatric facilities remains unclear.
Purpose of the Study:
- To evaluate the impact of discontinuing CP for MRSA on infection rates in a pediatric healthcare system.
- To determine if the experience in adult facilities can be extrapolated to pediatric settings.
Main Methods:
- Contact precautions for MRSA were removed in a 3-hospital pediatric system, excluding the NICU, in September 2019.
- Surveillance for LabID healthcare facility-onset MRSA infections was conducted from September 2017 to August 2023.
- Interrupted time series analysis and aggregate rate ratios were used to analyze infection incidence density.
Main Results:
- No significant change in the incidence density rate of MRSA infections was observed after discontinuing CP (ITS slope P=0.78, intercept P=0.47).
- Aggregate incidence density rate ratio for MRSA events was 0.98 (95% CI: 0.74 to 1.28), indicating no significant change.
- MRSA nasal colonization rates and contact isolation days also showed no significant changes.
Conclusions:
- Discontinuation of CP for pediatric MRSA patients was not associated with increased MRSA infections over a 4-year period.
- These findings support considering the removal of CP for MRSA in similar pediatric settings with strong adherence to general infection prevention measures.
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...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:23Hand hygiene
Hand washing...
01:28Asepsis