Does the Removal of Contact Precautions for MRSA and VRE Infected Patients Change Health Care-Associated Infection Rate?: A Systematic Review and Meta-Analysis.
Hospital-associated infectio, Methicillin-resistant Staphylococcus aureus, Vancomycin-resistant Enterococcus
Bacterial Infections and Mycoses | Infectious Disease | Quality Improvement
OBJECTIVE: Update existing meta-analysis to analyze if discontinuation of contact precautions (CPs) for Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin resistant Enterococcus (VRE) colonization or infection affects hospital-associated MRSA or VRE infection rates.
METHODS: We conducted a systematic review of 17 studies evaluating discontinuation of CPs for MRSA and VRE. Random-effects and fixed-effects models were used to determine the pooled risk ratios (RR) of preincidence hospital-associated infection rate to postincidence rate. Subgroup analysis was used to assess sources of heterogeneity.
RESULTS: No significant difference between rates of hospital-associated MRSA infection before and after stopping the CPs was observed (RR, 0.84; 95% confidence internal [CI], 0.71-1.01; P = .06). An inverse association was observed between discontinuation of CPs and rates of hospital-associated VRE infection (RR, 0.82; 95% CI, 0.72-0.94; P = .005). A subgroup analysis of 6 studies that used chlorhexidine, showed no difference between rates of hospital-associated MRSA infection with discontinuation of CPs (RR, 0.83; 95% CI, 0.69-1.00; P = .05). In 5 studies that did not use chlorhexidine, there was no difference between rates of hospital-associated MRSA infection with discontinuation of CPs (RR, 1.02; 95% CI, 0.55-1.88; P= .95).
CONCLUSIONS: There was no significant difference in rates of hospital-associated MRSA infection before and after removing CPs. Additionally, there were decreased rates of hospital-associated VRE infection following stoppage of CPs.
Publisher or Conference
American Journal of Infection Control
Kleyman R, Cupril-Nilson S, Robinson K, et al. Does the removal of contact precautions for MRSA and VRE infected patients change health care-associated infection rate?: A systematic review and meta-analysis [published online ahead of print, 2020 Dec 1]. Am J Infect Control. 2020;S0196-6553(20)31029-4. doi:10.1016/j.ajic.2020.11.020