Contact precautions, such as wearing gowns or gloves, are thought to stem the spread of infectious pathogens and cut down on the rate of health care-associated infections (HAIs). But a group of investigators has demonstrated that discontinuing contact precautions for methicillin-resistant Staphylococcus aureus
(MRSA) and vancomycin-resistant Enterococcus
(VRE) did not lead to an increase the rate of HAIs within a large health system with control hospitals.
The research team from the University of Pittsburgh Medical Center presented their findings at the Society for Healthcare Epidemiology of America Spring Conference (SHEA 2019
A collective, system-wide decision was made to stop employing contact precautions at 12 hospitals (bed size range 40-495) on February 15, 2018. The precautions continued at 3 control hospitals (bed size range 315-745). Investigators pulled data from the US Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN) to calculate the rates of MRSA and VRE HAIs between January 2017 and September 2018, and MRSA LabID events from March 2017 to September 2018. Investigators use Poisson regression to analyze data and compared with controls. The month of February 2018 was excluded as a wash-in period.
None of the hospitals saw a statistically significant increase in MRSA or VRE HAI rates after discontinuing contact precautions, and aggregated average HAI rates from all 12 hospitals also showed no statistically significant increase, even after comparing with controls. The aggregated average HAI rates before and after discontinuing contact precautions were 0.14 and 0.15 MRSA HAI/1000 patient days, 0.06 and 0.04 VRE HAI/1000 patient days, and 0.04 and 0.03 MRSA LabID events/100 admissions.
“Discontinuing contact precautions for MRSA/VRE did not result in increased rates of MRSA or VRE HAIs after seven months, suggesting contact precautions may be removed without increased infections in a large health system, including community hospitals,” investigators concluded.
The study, “No Increase in MRSA or VRE Healthcare-Associated Infections After Discontinuing Routine Contact Precautions in a Large Health System,” was presented in an oral session on April 26, 2019, at SHEA in Boston, Massachusetts.
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