AI Article Synopsis
- Several studies suggest that stopping contact precautions (CPs) for MRSA and VRE in nonoutbreak situations does not increase infection rates.
- A systematic review and meta-analysis examined various studies and found a slight decrease in MRSA infections and a significant decrease in VRE infections after CPs were discontinued.
- Overall, the findings indicate that removing CPs for these multidrug-resistant organisms does not lead to higher rates of infection.
Article Abstract
Background: Several single-center studies have suggested that eliminating contact precautions (CPs) for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) control in nonoutbreak settings has no impact on infection rates. We performed a systematic literature review and meta-analysis on the impact of discontinuing contact precautions in the acute care setting.
Methods: We searched PubMed, CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, and Embase through December 2016 for studies evaluating discontinuation of contact precautions for multidrug-resistant organisms. We used random-effect models to obtain pooled risk ratio estimates. Heterogeneity was evaluated with I estimation and the Cochran Q statistic. Pooled risk ratios for MRSA and VRE were assessed separately.
Results: Fourteen studies met inclusion criteria and were included in the final review. Six studies discontinued CPs for both MRSA and VRE, 3 for MRSA only, 2 for VRE only, 2 for extended-spectrum β-lactamase-producing Escherichia coli, and 1 for Clostridium difficile infection. When study results were pooled, there was a trend toward reduction of MRSA infection after discontinuing CPs (pooled risk ratio, 0.84; 95% confidence interval, 0.70-1.02; P = .07) and a statistically significant reduction in VRE infection (pooled risk ratio, 0.82; 95% confidence interval, 0.72-0.94; P = .005).
Conclusions: Discontinuation of CPs for MRSA and VRE has not been associated with increased infection rates.
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| http://dx.doi.org/10.1016/j.ajic.2017.08.031 | DOI Listing |
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