January 26, 2024
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Key takeaways:
- Discontinuing contact precautions at three pediatric hospitals was not associated with an increase in MRSA.
- The data support discontinuing contact precautions for MRSA in similar settings, researchers said.
Three pediatric hospitals that discontinued contact precautions for MRSA did not see an associated increase in MRSA over the course of the next 4 years, according to researchers published in the Journal of the Pediatric Infectious Diseases Society.
The Infectious Diseases Society of America and other groups consider contact precautions an “essential practice” for preventing MRSA despite what experts have argued is a lack of evidence supporting the practice.
“In 2019, our hospital discontinued the long-standing practice of placing all patients with MRSA infection or colonization on contact precautions while hospitalized,” Zachary M. Most, MD, MSc, a pediatric infectious disease specialist at UT Southwestern Medical Center in Dallas and co-author of the new study, told Healio. “Historically, MRSA has been considered such a target organism due to the potential severity of MRSA infections, the possibility of transmission between individuals in health care settings and the limited antimicrobials that can be used to treat these infections.”
In September 2019, the Texas-based Children’s Health system chose to discontinue contact precautions for MRSA — except in the NICUs — at all three of its hospitals
“The reason why we discontinued contact precautions for MRSA in the first place was because we felt there was sufficient evidence that it would be safe,” Most said.
Most and colleagues analyzed data from 766,020 patient-days from Sept. 1, 2017, through Aug. 31, 2023 — before and after the hospitals ended contact precautions — and found 234 incident hospital-onset MRSA infections.
In the period after they discontinued contact precautions, modeling showed no change in the rate of facility-onset MRSA, nor of MRSA nasal colonization among patients being screened before cardiac surgery. Additionally, the prevalence rate of contact isolation days decreased by 14%.
Most noted that a 2022 compendium by the IDSA and others outlining strategies to prevent MRSA transmission in acute-care hospitals lists as an essential practice that facilities that are considering discontinuing contact precautions conduct an MRSA-specific risk assessment.
“We hope that pediatric health care institutions will take our experience into account when performing their own risk assessments,” Most said.
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