Are contact precautions "essential" for the prevention of healthcare-associated methicillin-resistant Staphylococcus aureus?
Daniel J DiekemaPriya NoriMichael P StevensMatthew W SmithK C CoffeyDaniel J MorganPublished in: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2023)
The recently updated SHEA/IDSA/APIC practice recommendations for MRSA prevention in acute care facilities list contact precautions (CP) for patients known to be infected or colonized with MRSA as an "essential practice", meaning that it should be adopted in all acute care facilities. We argue that existing evidence on benefits and harms associated with CP do not justify this recommendation. There are no controlled trials that support broad use of CP for MRSA prevention. Data from hospitals that have discontinued CP for MRSA have found no impact on MRSA acquisition or infection. The burden and harms of CP remain concerning, including the environmental impact of increased gown and glove use. We suggest that CP be included among other "additional approaches" to MRSA prevention that can be implemented under specific circumstances (e.g. outbreaks, evidence of ongoing transmission despite application of essential practices).
Keyphrases
- methicillin resistant staphylococcus aureus
- acute care
- healthcare
- staphylococcus aureus
- primary care
- end stage renal disease
- ejection fraction
- machine learning
- chronic kidney disease
- quality improvement
- risk factors
- palliative care
- patient reported outcomes
- social media
- health information
- advanced cancer
- life cycle
- patient reported