Are contact isolation precautions (CP) necessary when caring for patients infected or colonized with endemic MRSA or VRE?

Researchers from the University of Nebraska Medical Center Division of Infectious Diseases and Nebraska Medicine Department of Infection Control and Epidemiology recently published results from a two-year observational study indicating that routine use of contact isolation precautions (CP) are not needed in caring for patients with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). (Rupp ME, et al.  Infection Control and Hospital Epidemiology 38:1005-1007, 2017).

The CDC has long recommended use of CP (i.e. private room, gowns and gloves, limitation of potential fomites) when caring for patients colonized or infected with multi-drug resistant pathogens (MRSA, VRE).  However, some studies have indicated that CP adversely influence provider behavior (fewer and shorter provider-patient interactions) and may result in delays in patient admissions and transfers, excess adverse events, and psychologic harm.

In the UNMC two-year quasi-experimental before-after study, it was noted that the rate of infection due to MRSA or VRE did not change in the yearlong period after CP were discontinued compared to the previous year.  However, it was also noted that the discontinuation of CP was conducted in an institution with excellent horizontal infection control interventions in place [hand hygiene (>90%), careful attention to environmental cleanliness (>90% clean rate on high-touch surfaces) and a practice of routine patient bathing with chlorohexidine].

This recently published paper adds additional support for re-examining the need for CP in the routine care of patients colonized/infected with endemic MRSA or VRE.

Read the article at:

Content courtesy of Dr. Mark Rupp. 

See more from the UNMC ID Division here.


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