Reviewed by: Sonali Advani, MBBS, MPH, Duke University School of Medicine
Haessler et al. performed a retrospective multicenter interrupted time series at three academic hospitals to study the impact of discontinuing contact precautions (CP) for patients with contained body fluids who are colonized or infected with methicillin resistant Staphylococcus aureus (MRSA) or Vancomycin resistant Enterococci (VRE). Other infection prevention (IP) measures continued, including CP for other organisms, hand hygiene, pre-operative chlorhexidine showers and UV light disinfection. The primary outcomes were rates of central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), mediastinal surgical site infection (SSI), and ventilator-associated pneumonia (VAP). CLABSI, CAUTI, SSI, and VAP rates trended down at each institution (not statistically significant) after discontinuing CP, likely due to horizontal infection prevention practices. These findings are similar to results from other quasi-experimental studies that found no negative impact. Limitations include short duration of study, lack of randomization, lack of compliance data with other IP measures to account for confounders, and a primary focus on MRSA without discussion of MSSA rates.
Haessler S, Martin EM, Scales ME et al. Stopping the Routine use of Contact Precautions for Management of MRSA and VRE at Three Academic Medical Centers: An Interrupted Time Series Analysis. American Journal of Infection Control. 2020 Jul 4:S0196-6553(20)30642-8. https://www.ajicjournal.org/article/S0196-6553(20)30642-8/abstract