LIFTING CONTACT PRECAUTIONS FOR METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) ISOLATION: EFFECT ON MRSA INFECTION MEASURES

Abstract

ABSTRACT Objective. To investigate the impact of discontinuing contact precautions (CP) among patients infected with Methicillin-resistant Staphylococcus aureus (MRSA) on rates of healthcare-associated infections (HAI). Design. Single center, retrospective, nonrandomized, observational, quasi-experimental study. Participants. All patients affected by MRSA and hospitalized from January 2013 to September 2018. Methods. We compared HAIs rates between pre and post intervention periods. Data on primary outcomes Central line-associated bloodstream infections (CLABSI) and MRSA LabID bacteremia events were analyzed by interrupted time series design using segmented Poisson regression modeling. Secondary outcomes catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), surgical site infections (SSI) and hospital-acquired pneumonia (HAP) were compared using Fisher’s exact tests. Results. 403 patients developed HAIs during 68 months’ study period. Infection rates between pre and post periods were as follows: (1) CLABSI: (0.0179% vs. 0.0157%; p-value= 0.64), (2) MRSA LabID events: (0.0130% vs. post: 0.0150%; p-value= 0.32), (3) HAP: (0.0078% vs. 0.0086%; p-value=0.64), (4) CAUTI: (0% vs. 0.0016%; p-value=0.56), (5) VAP: (0.0049% vs. 0.0133%; p-value=0.32), (6) SSI (0.5476% vs. 0.1536%; p-value= 0.03). Conclusion. Discontinuing CP did not negatively impact endemic MRSA healthcare associated infection rates between pre-post discontinuation period.