Routine Use of Contact Precautions for MRSA and VRE: Which Way is the Pendulum Swinging?
Methods: 751 physician members of the Emerging Infections Network (EIN) who had identified themselves as having interest or involvement in infection prevention/infection control were invited to complete an electronic survey. The survey, which remained open for 4 weeks, contained 8 questions designed to ascertain current practices related to reducing transmission of MRSA and VRE.
Results: 429 members responded to the survey (57.7%). Respondents reported ongoing use of routine CP for MRSA (93%) and VRE (92%). The most widely used trigger for CP for both pathogens was positive clinical culture (97%), followed by pre-existing alert in the electronic record (90%), then positive surveillance culture (76%); practices for discontinuation of isolation varied widely. 81% reported performing MRSA active surveillance testing (AST) and 34% perform VRE AST for specific inpatient populations. 85% perform CHG bathing and 64% perform S. aureus decolonization with mupirocin for one or more subsets of inpatients. 23% reported using either hydrogen peroxide vapor or UVC light as means of room disinfection at discharge. Free text responses noted frustration and heterogeneity in the application, practice, and discontinuation of CP.
Conclusion: Routine use of CP for MRSA and VRE remains commonplace, although horizontal interventions such as CHG bathing are increasingly used. Respondents frequently questioned the value of routine CP. The heterogeneity of practices & policies was striking, and may be guided by regulatory pressure. Evidence-based guidelines from professional organizations regarding CP and horizontal interventions are needed.
P. M. Polgreen, None
Z. Rubin, None
D. Z. Uslan, None