Duration of Contact Precautions for Acute-Care Settings

• Published in: Infection control and hospital epidemiology 2018-02, Vol.39 (2), p.127-144
• Main Authors: Banach, David B, Bearman, Gonzalo, Barnden, Marsha, Hanrahan, Jennifer A, Leekha, Surbhi, Morgan, Daniel J, Murthy, Rekha, Munoz-Price, L Silvia, Sullivan, Kaede V, Popovich, Kyle J, Wiemken, Timothy L
• Format: Article
• Language: English
• Subjects: Antibiotic resistance; Clostridium difficile - isolation & purification; Clostridium Infections - diagnosis; Clostridium Infections - prevention & control; Cross Infection - prevention & control; Development policy; Disease control; Drug Resistance, Multiple, Bacterial; Enterobacteriaceae - isolation & purification; Enterobacteriaceae Infections - diagnosis; Enterobacteriaceae Infections - prevention & control; Epidemiology; Hospitals; Humans; Infection Control - methods; Infection Control - standards; Laboratories; Long term health care; Long-term care; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Nursing; Organisms; Patients; Public health; Societies, Scientific; Staphylococcal Infections - diagnosis; Staphylococcal Infections - prevention & control; Staphylococcus infections; Universal Precautions - methods; Vancomycin-Resistant Enterococci - isolation & purification
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1017/ice.2017.245

PURPOSE This expert guidance document (EG) provides recommendations regarding discontinuation of contact precautions (CP) at the individual patient level in acute-care hospitals employing CP for 1 or more of the following organisms: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and multidrug-resistant Enterobacteriaceae (MDR-E), including carbapenem-resistant Enterobacteriaceae (CRE) and extended-spectrum β-lactamase (ESBL)–producing organisms. All authors are involved at their respective institutions in the development of policies pertaining to CP, either directly or in an advisory role. For high-risk patients, such as those with chronic wounds or patients from long-term care facilities, we recommend extending CP from the last MRSA-positive culture, prior to assessing for CP discontinuation. 4. Patients with chronic wounds and those from long-term care facilities may be at higher risk for persistent MRSA colonization and recolonization13; thus, for these patients, hospitals may extend CP.