Contact precautions for the control of endemic pathogens: Finding the middle path

Bearman, Gonzalo; Harris, Anthony D.; Tacconelli, Evelina

doi:10.1017/ash.2023.145

ASHE

2023

DOI: 10.1017/ash.2023.145

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Contact precautions for the control of endemic pathogens: Finding the middle path

Gonzalo Bearman

Anthony D. Harris²,

Evelina Tacconelli³

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Cited by 7 publications

(1 citation statement)

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“…3 Which MDROs should require contact precautions is unclear and frequently debated. [4][5][6][7] Much of the data referenced in the 2007 HICPAC guidelines evaluated the impact of contact precautions on MDRO transmission as part of larger infection-prevention bundles, making it difficult to assess the relative contribution of contact precautions. 1,2 Prior to the coronavirus disease 2019 (COVID-19) pandemic, some healthcare facilities stopped routinely recommending contact precautions for MRSA and VRE and did not see an increase in healthcare associated infections (HAIs) due to these organisms.…”

mentioning

confidence: 99%

Implementation of contact precautions for multidrug-resistant organisms in the post–COVID-19 pandemic era: An updated national Emerging Infections Network (EIN) survey

Howard-Anderson,

Gottlieb,

Beekmann

et al. 2024

Infect. Control Hosp. Epidemiol.

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Objective: To understand how healthcare facilities employ contact precautions for patients with multidrug-resistant organisms (MDROs) in the post–coronavirus disease 2019 (COVID-19) era and explore changes since 2014. Design: Cross-sectional survey. Participants: Emerging Infections Network (EIN) physicians involved in infection prevention or hospital epidemiology. Methods: In September 2022, we sent via email an 8-question survey on contact precautions and adjunctive measures to reduce MDRO transmission in inpatient facilities. We also asked about changes since the COVID-19 pandemic. We used descriptive statistics to summarize data and compared results to a similar survey administered in 2014. Results: Of 708 EIN members, 283 (40%) responded to the survey and 201 reported working in infection prevention. A majority of facilities (66% and 69%) routinely use contact precautions for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) respectively, compared to 93% and 92% in 2014. Nearly all (>90%) use contact precautions for Candida auris, carbapenem-resistant Enterobacterales (CRE), and carbapenem-resistant Acinetobacter baumannii. More variability was reported for carbapenem-resistant Pseudomonas aeruginosa and extended-spectrum β-lactamase–producing gram-negative organisms. Compared to 2014, fewer hospitals perform active surveillance for MRSA and VRE. Overall, 90% of facilities used chlorhexidine gluconate bathing in all or select inpatients, and 53% used ultraviolet light or hydrogen peroxide vapor disinfection at discharge. Many respondents (44%) reported changes to contact precautions since COVID-19 that remain in place. Conclusions: Heterogeneity exists in the use of transmission-based precautions and adjunctive infection prevention measures aimed at reducing MDRO transmission. This variation reflects a need for updated and specific guidance, as well as further research on the use of contact precautions in healthcare facilities.

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mentioning

confidence: 99%

Implementation of contact precautions for multidrug-resistant organisms in the post–COVID-19 pandemic era: An updated national Emerging Infections Network (EIN) survey

Howard-Anderson,

Gottlieb,

Beekmann

et al. 2024

Infect. Control Hosp. Epidemiol.

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Personalized infection prevention and control: a concept whose time has arrived

Savoldi,

Mutters,

Tacconelli

2023

ASHE

Self Cite

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Personalized medicine has been progressively implemented in several diagnostic and therapeutic patients’ algorithms, based on the common assumption that tailoring interventions, practices, and/or therapies to individual patients’ clinical, biological, epidemiological, and genetic characteristics would optimize their effectiveness and reduce adverse effects. The potential benefit of the precision medicine approach has been recently considered for possible implementation in the field of infection prevention and control. The commentary explores available evidence and assesses possible future scenarios where, through advanced modeling approaches, we would be able to provide personalized prediction algorithms identifying at-risk patients who deserve the implementation of tailored preventive measures.

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A survey of healthcare workers on the acceptance and value of personal protective equipment for patient care

Schrank,

O’Hara,

Pineles

et al. 2024

Infect. Control Hosp. Epidemiol.

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Objective: Assess healthcare workers’ (HCW) attitudes toward universal masking, and gowns and gloves used as part of transmission-based precautions. Design: Cross-sectional survey. Setting: Academic, tertiary care medical center in Baltimore, Maryland. Participants: HCW who work in patient care areas and have contact with patients. Methods: In May 2023, a 15-question web-based survey was distributed by the hospital’s communications team via email. The survey contained questions to assess HCW perceptions of universal masking policies prior to the availability of COVID-19 vaccines and at the time of the survey, and the use of gowns and gloves for transmission-based precautions. Descriptive statistics were used to summarize data. Differences in agreement with universal masking over time, level of agreement with gown and glove policies, and with all PPE types across respondent characteristics were assessed. Results: 257 eligible respondents completed the survey. Nurses and patient care technicians (43%) and providers (17%) were the most commonly reported roles. Agreement with universal mask use decreased from 84% early in the pandemic to 55% at the time of the survey. 70% and 72% of HCW agreed masks protect themselves and others, respectively. 63% expressed any level of annoyance with mask wearing, the most often due to communication challenges or physical discomfort. 75% agreed with gown use for antibiotic-resistant bacteria compared with 90% for glove use. Conclusions: The majority of HCW agree with the use of PPE to prevent pathogen transmission in the healthcare setting. Agreement with universal mask use for patient care shifted during the COVID-19 pandemic.

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Contact precautions for the control of endemic pathogens: Finding the middle path

Cited by 7 publications

References 19 publications

Implementation of contact precautions for multidrug-resistant organisms in the post–COVID-19 pandemic era: An updated national Emerging Infections Network (EIN) survey

Implementation of contact precautions for multidrug-resistant organisms in the post–COVID-19 pandemic era: An updated national Emerging Infections Network (EIN) survey

Personalized infection prevention and control: a concept whose time has arrived

A survey of healthcare workers on the acceptance and value of personal protective equipment for patient care

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