Evaluation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus.
Bardossy AC, Alsafadi MY, Starr P, Chami E, Pietsch J, Moreno D, Johnson L, Alangaden G, Zervos M, and Reyes K. Evaluation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus Am J Infect Control 2017; 45(12):1369-1371.
Am J Infect Control
BACKGROUND: There are limited controlled data demonstrating contact precautions (CPs) prevent methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) infections in endemic settings. We evaluated changes in hospital-acquired MRSA and VRE infections after discontinuing CPs for these organisms.
METHODS: This is a retrospective study done at an 800-bed teaching hospital in urban Detroit. CPs for MRSA and VRE were discontinued hospital-wide in 2013. Data on MRSA and VRE catheter-associated urinary tract infections (CAUTIs), ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs), surgical site infections (SSIs), and hospital-acquired MRSA bacteremia (HA-MRSAB) rates were compared before and after CPs discontinuation.
RESULTS: There were 36,907 and 40,439 patients hospitalized during the two 12-month periods: CPs and no CPs. Infection rates in the CPs and no-CPs periods were as follows: (1) MRSA infections: VAP, 0.13 versus 0.11 (P = .84); CLABSI, 0.11 versus 0.19 (P = .45); SSI, 0 versus 0.14 (P = .50); and CAUTI, 0.025 versus 0.033 (P = .84); (2) VRE infections: CAUTI, 0.27 versus 0.13 (P = .19) and CLABSI, 0.29 versus 0.3 (P = .94); and (3) HA-MRSAB rates: 0.14 versus 0.11 (P = .55), respectively.
CONCLUSIONS: Discontinuation of CPs did not adversely impact endemic MRSA and VRE infection rates.
Medical Subject Headings
Bacteremia; Cross Infection; Humans; Infection Control; Methicillin-Resistant Staphylococcus aureus; Pneumonia, Ventilator-Associated; Population Surveillance; Retrospective Studies; Staphylococcal Infections; Vancomycin-Resistant Enterococci