Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-25T08:45:50.653Z Has data issue: false hasContentIssue false
  • English
  • Français

“Bringing Down the Flag”: Removing the Contact Precautions Label for Non-hospitalized Patients with Prior Methicillin-Resistant Staphylococcus aureus Infection or Colonization

Published online by Cambridge University Press:  28 January 2015

Paul J. Carson ,
Mallory Danford ,
Grace Carson ,
Christine Hanish ,
Jody Thompson ,
Megan Orr ,
Michael Traynor ,
Felix Roth  and
Dubert Guerrero
Paul J. Carson*
Affiliation:
North Dakota State University, Master of Public Health Program, Fargo, North Dakota Sanford Health, Fargo, Department of Infectious Disease, Fargo, North Dakota University of North Dakota School of Medicine, Department of Medicine, Grand Forks, North Dakota.
Mallory Danford
Affiliation:
North Dakota State University, Master of Public Health Program, Fargo, North Dakota
Grace Carson
Affiliation:
Sanford Health, Fargo, Department of Infectious Disease, Fargo, North Dakota University of North Dakota School of Medicine, Department of Medicine, Grand Forks, North Dakota.
Christine Hanish
Affiliation:
Sanford Health, Fargo, Department of Infectious Disease, Fargo, North Dakota
Jody Thompson
Affiliation:
Sanford Health, Fargo, Department of Infectious Disease, Fargo, North Dakota
Megan Orr
Affiliation:
North Dakota State University, Master of Public Health Program, Fargo, North Dakota
Michael Traynor
Affiliation:
University of North Dakota School of Medicine, Department of Medicine, Grand Forks, North Dakota.
Felix Roth
Affiliation:
Sanford Health, Fargo, Department of Infectious Disease, Fargo, North Dakota
Dubert Guerrero
Affiliation:
Sanford Health, Fargo, Department of Infectious Disease, Fargo, North Dakota University of North Dakota School of Medicine, Department of Medicine, Grand Forks, North Dakota.
*
Address correspondence to Paul Carson, MD, FACP, North Dakota State University, P.O. Box 6050, Fargo, ND 58108-6050 ([email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

A policy consensus has not been reached regarding discontinuing contact precautions in patients with a history of methicillin-resistant Staphylococcus aureus (MRSA). We found that as many as 72% of outpatients flagged for past MRSA were no longer carriers, and a single nasal PCR test provided a reasonable negative predictive value for removing contact precautions.

Infect Control Hosp Epidemiol 2015;00(0): 1–3

Type
Concise Communications
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 5 , May 2015 , pp. 578 - 580
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

PRIOR PRESENTATION. Study results were presented at the annual American Public Health Association Meeting, November, 2014, New Orleans, Louisiana.

References

1. Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control, 2007(35 2):S65–S164.Google Scholar
2. Abad, C, Fearday, A, Safdar, N. Adverse effects of isolation in hospitalised patients: a systematic review. J Hosp Infect 2010;76:97–102.Google Scholar
3. Shenoy, ES, Hsu, H, Noubary, F, Hooper, DC, Walensky, RP. National survey of infection preventionists: policies for discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus. Infect Control Hosp Epidemiol 2012;33:1272–1275.Google Scholar
4. Shenoy, ES, Kim, J, Rosenberg, ES, et al. Discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus: a randomized controlled trial comparing passive and active screening with culture and polymerase chain reaction; supplementary appendix. Clin Infect Dis 2013;57:176–184.Google Scholar
5. Vikram, HR, Dumigan, DG, Kohan, C, Havill, NL, Tauman, A, Boyce, JM. Discontinuation of contact precautions for patients no longer colonized with methicillin-resistant Staphylococcus aureus . Infect Control Hosp Epidemiol 2010;31:541–543.Google Scholar
6. Wassenberg, MW, Kluytmans, JA, Bosboom, RW, et al. Rapid diagnostic testing of methicillin-resistant Staphylococcus aureus carriage at different anatomical sites: costs and benefits of less extensive screening regimens. Clin Microbiol Infect 2011;17:1704–1710.Google Scholar
7. Baker, SE, Brecher, SM, Robillard, E, Strymish, J, Lawler, E, Gupta, K. Extranasal methicillin-resistant Staphylococcus aureus colonization at admission to an acute care Veterans Affairs hospital. Infect Control Hosp Epidemiol 2010;31:42–46.Google Scholar
8. Hombach, M, Pfyffer, GE, Roos, M, Lucke, K. Detection of methicillin-resistant Staphylococcus aureus (MRSA) in specimens from various body sites: performance characteristics of the BD GeneOhm MRSA assay, the Xpert MRSA assay, and broth-enriched culture in an area with a low prevalence of MRSA infections. J Clin Microbiol 2010;48:3882–3887.Google Scholar
9. Scanvic, A, Denic, L, Gaillon, S, Giry, P, Andremont, A, Lucet, JC. Duration of colonization by methicillin-resistant Staphylococcus aureus after hospital discharge and risk factors for prolonged carriage. Clin Infect Dis 2001;32:1393–1398.Google Scholar
10. MacKinnon, MM, Allen, KD. Long-term MRSA carriage in hospital patients. J Hosp Infect 2000;46:216–221.Google Scholar