Reconsidering Isolation Precautions for Endemic Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus

Gowns, gloves, and hand hygiene are primary tools for preventing transmission of pathogens in health care settings. The CDC recommends that these approaches be used for all patients as a part of standard precautions, which include hand hygiene on room entry and exit and after touching the environment or before touching a sterile site, and the addition of gloves, gowns, or both for patient care that involves risk for exposure to body fluids, mucous membranes, or nonintact skin. Despite the widespread use of contact precautions, there is little evidence these measures prevent methicillin-resistant staphylococcus aureus (MRSA) or vancomycin-resistant enterococcus (VRE) infections in endemic, nonoutbreak settings (the current situation in most US hospitals). No interventional study has compared MRSA or VRE acquisition rates with contact precautions vs standard precautions. Here, Morgan et al discuss reconsidering isolation precautions for endemic MRSE and VRE.