Long-term impact of contact precautions cessation for Methicillin-Resistant Staphylococcus Aureus (MRSA)

•Contact Isolation is a recommended infection prevention measure against Methicillin-Resistant Staphylococcus aureus (MRSA) healthcare-associated infections (HAI).•Growing evidence suggest MRSA contact isolation may not be effective.•Discontinuation of MRSA contact isolation did not affect MRSA HAI...

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Veröffentlicht in:American journal of infection control 2022-03, Vol.50 (3), p.336-341
Hauptverfasser: AlMohanna, Zainab, Snavely, Anna C., Viviano, James P, Bischoff, Werner E.
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Sprache:eng
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Zusammenfassung:•Contact Isolation is a recommended infection prevention measure against Methicillin-Resistant Staphylococcus aureus (MRSA) healthcare-associated infections (HAI).•Growing evidence suggest MRSA contact isolation may not be effective.•Discontinuation of MRSA contact isolation did not affect MRSA HAI over time.•MRSA isolation discontinuation improves individual patient care and saves costs. Methicillin-Resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections (HAI). Contact isolation has been traditionally implemented to stop transmission but its impact is increasingly questioned. A single center, retrospective, nonrandomized, observational, quasi-experimental study compared MRSA HAI rates between pre-/postdiscontinuation of MRSA contact isolation in a tertiary university hospital over 68 months. Data on primary outcomes, Central line-associated bloodstream infections and MRSA LabID bacteremia events, were analyzed by interrupted time series design using segmented Poisson regression modeling. As secondary outcomes catheter-associated urinary tract infections , ventilator-associated pneumonia , surgical site infections and hospital-associated pneumonia were compared using Fisher's exact tests. Current savings due to discontinuation were calculated based on gown use. Two hundred and ninty-five patients developed 399 HAIs. Infection rates between pre- and postinterventions were as follows: Central line-associated bloodstream infections: (0.02% vs 0.02%; P-value = .64), MRSA LabID events: (0.01% vs 0.02%; P-value = .32), hospital-associated pneumonia: (0.01% vs 0.01%; P-value = .64), catheter-associated urinary tract infections: (0% vs 0.01%; P-value = .56), ventilator-associated pneumonia: (0.01% vs 0.01%; P-value = .32), surgical site infections (0.55% vs 0.15%; P-value = .03). Savings amount to $139,228 annually. Discontinuing CP did not negatively impact endemic MRSA HAI rates between pre-postdiscontinuation periods and saved costs for isolation materials.
ISSN:0196-6553
1527-3296
DOI:10.1016/j.ajic.2021.10.044