Journal article
Routine Use of Contact Precautions for Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus: Which Way Is the Pendulum Swinging?
Infection control and hospital epidemiology, Vol.37(1), pp.36-40
01/01/2016
DOI: 10.1017/ice.2015.246
PMID: 26486272
Abstract
BACKGROUND Studies have suggested that contact precautions (CP) for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus may have risks that outweigh the benefits. These risks, coupled with more widespread use of horizontal interventions such as daily bathing with chlorhexidine gluconate, have brought into question the value of routine CP for these organisms.
OBJECTIVE To assess the state of utilization of CP as well as adjunctive measures to reduce the risk of transmission in US hospitals.
DESIGN Cross-sectional survey.
PARTICIPANTS Total of 751 physician members of the Emerging Infections Network.
METHODS An 8-question electronic survey distributed by email.
RESULTS A total of 426/751 (57%) responded to the survey; 337/364 (93%) of respondents use routine CP for methicillin-resistant S. aureus and 335/364 (92%) use routine CP for vancomycin-resistant enterococcus. The most widely used trigger for initiation of CP for both pathogens was positive clinical culture. Practices for discontinuation of isolation varied widely. We found that 325/354 (92%) perform routine chlorhexidine gluconate bathing and 236/353 (67%) perform S. aureus decolonization with mupirocin for 1 or more subsets of inpatients, and 82/356 (23%) reported using either hydrogen peroxide vapor or ultraviolet-C room disinfection at discharge. Free text responses noted frustration and variation in the application, practice, and process for initiation and discontinuation of CP.
CONCLUSIONS Use of CP for methicillin-resistant S. aureus and vancomycin-resistant enterococcus remains commonplace, although horizontal interventions such as chlorhexidine gluconate bathing are increasingly used. The heterogeneity of practices and policies was striking. Evidence-based guidelines regarding CP and horizontal interventions are needed. Infect. Control Hosp. Epidemiol. 2015;37(1):36-40
Details
- Title: Subtitle
- Routine Use of Contact Precautions for Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus: Which Way Is the Pendulum Swinging?
- Creators
- Dana Russell - UCLA HealthSusan E. Beekmann - University of IowaPhilip M. Polgreen - Roy J. and Lucille A. Carver College of MedicineZachary Rubin - University of California, Los AngelesDaniel Z. Uslan - University of California, Los Angeles
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.37(1), pp.36-40
- DOI
- 10.1017/ice.2015.246
- PMID
- 26486272
- NLM abbreviation
- Infect Control Hosp Epidemiol
- ISSN
- 0899-823X
- eISSN
- 1559-6834
- Publisher
- Cambridge Univ Press
- Number of pages
- 5
- Grant note
- R01HS021188 / AGENCY FOR HEALTHCARE RESEARCH AND QUALITY; United States Department of Health & Human Services; Agency for Healthcare Research & Quality FOA CK11-1102 / Centers for Disease Control and Prevention; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA
- Language
- English
- Date published
- 01/01/2016
- Academic Unit
- Infectious Diseases; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984359587302771
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