Evaluation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus

Am J Infect Control. 2017 Dec 1;45(12):1369-1371. doi: 10.1016/j.ajic.2017.06.017. Epub 2017 Aug 24.

Abstract

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.

Keywords: Contact precautions; Methicillin-resistant Staphylococcus aureus; Vancomycin-resistant Enterococcus.

MeSH terms

  • Bacteremia / epidemiology
  • Bacteremia / prevention & control
  • Cross Infection / prevention & control*
  • Humans
  • Infection Control
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Pneumonia, Ventilator-Associated / epidemiology
  • Pneumonia, Ventilator-Associated / prevention & control*
  • Population Surveillance*
  • Retrospective Studies
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / prevention & control*
  • Vancomycin-Resistant Enterococci / isolation & purification*