Effect of Cessation of Contact Isolation for Endemic Methicillin-Resistant <i>Staphylococcus aureus</i> and Vancomycin-Resistant Enterococci

Rupp, Mark E.; Fitzgerald, Teresa; Hayes, Kim F.; Schooneveld, Trevor Van; Hewlett, Angela; Clevenger, Ryan; Lyden, Elizabeth

doi:10.1017/ice.2017.122

Cited by 14 publications

(9 citation statements)

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“…Majority (15/17) of these 17 studies were conducted in the United States, [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] one study was conducted in Canada, 26 and one in France. 27 Fifteen studies compared HAI rates for specific microorganisms (MRSA, or VRE), 11,12,13,15,16,[18][19][20][21][22][23][24][25][26][27] and two studies compared device-associated HAI rates. 14,17 Most (15/17) of the included studies were nonrandomized quasiexperimental studies.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Four studies 12,14,19,22 investigated rates of hospital-associated VRE infection before and after removing CPs and used chlorhexidine, while 2 studies 16,26 did not use chlorhexidine. The pooled analysis for the four studies using chlorhexidine suggested evidence of difference between rates of hospital-associated VRE infection before and after stopping the CPs (RR, 0.79; 95% CI, 0.65-0.96; P = .01).…”

Section: Subgroup Analysismentioning

confidence: 99%

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Does the removal of contact precautions for MRSA and VRE infected patients change health care-associated infection rate?: A systematic review and meta-analysis

Kleyman

Cupril-Nilson

Robinson

et al. 2021

American Journal of Infection Control

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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.

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Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Subgroup Analysismentioning

confidence: 99%

Does the removal of contact precautions for MRSA and VRE infected patients change health care-associated infection rate?: A systematic review and meta-analysis

Kleyman

Cupril-Nilson

Robinson

et al. 2021

American Journal of Infection Control

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“…The epidemiology of resistance in Gram-positive bacteria has undergone major changes in recent decades, with methicillin-resistant S. aureus (MRSA) and VRE now being of international concern [6]. Antimicrobial resistances of Gram-positive bacteria have been reported in many countries [7–9]; however, it was only in recent years that vanM -carrying E. faecalis strains were isolated from patients and the clinical environment in the Second Affiliated Hospital of Zhejiang University School of Medicine [10], we speculate that if vanM infection has been spreading in the Zhejiang province, it may lead to an increase of VRE overall.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and risk factors of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci infections in Zhejiang China from 2015 to 2017

Huang

Zhang

et al. 2019

Antimicrob Resist Infect Control

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Background Gram-positive bacteria are dangerous and challenging agents of infection due to their increasing resistance to antibiotics. We aim to analyse the epidemiology and risk factors of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) in Zhejiang China. Methods Gram-positive bacteria (including S. aureus , Enterococcus faecalis and Enterococcus faecium ) were collected from eighty-six hospitals of eleven cities in Zhejiang China from 2015 to 2017. The detection rates of MRSA and VRE infection were calculated for the non-duplicated isolate according to year, region, hospital level, patient age, specimen type and patient category. Meanwhile, the detected resistances of MRSA, E. faecalis and E. faecium to different antibiotics from 2015 to 2017 were compared. The risk factors and the differences in MRSA and VRE detection rates were compared using odds ratio (OR) with 95% confidence interval (95% CI) and Chi-square test respectively. Results From 2015 to 2017, the detection rates of MRSA and VRE decreased gradually. The cities with the highest MRSA and VRE detection rates tended to be adjacent; for example, the neighbouring cities Hangzhou and Quzhou had simultaneously high rates of MRSA and VRE infection. Patients from IIIA hospital who were older than 75 years and in the intensive care unit (ICU) were most at risk. No vancomycin-resistant isolate was found in MRSA. Resistance of E. faecalis and E. faecium to vancomycin and linezolid decreased slightly and then maintained a low level. Conclusions The detection rates of MRSA and VRE stayed at moderate and low levels during the three year period of this study, while local dissemination was found in MRSA and VRE isolates. Sustained surveillance is necessary to prevent the spread or clonal dissemination of drug-resistant strains in Zhejiang China.

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“… 125 , 126 Infected and polluted hospital surfaces act as a key reservoir and source of transmission of life-threatening microorganisms, which include Clostridium difficile, antibiotic-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). 127 – 129 Hospital surfaces, including both porous surfaces, eg, beds, mattresses and linen, and nonporous surfaces, eg, bed rails, door handles, call bells, and light switches are incredibly prone to microbial contamination with high-risk microbes. 126 , 130 , 131 Maintaining strict hygiene throughout hospitals is, therefore, essential in reducing HCAIs.…”

Section: Methodsmentioning

confidence: 99%

<p>Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview</p>

Haque¹,

McKimm²,

Sartelli³

et al. 2020

RMHP

122

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Healthcare-associated infections (HCAIs) are a major source of morbidity and mortality and are the second most prevalent cause of death. Furthermore, it has been reported that for every one-hundred patients admitted to hospital, seven patients in high-income economies and ten in emerging and low-income economies acquire at least one type of HCAI. Currently, almost all pathogenic microorganisms have developed antimicrobial resistance, and few new antimicrobials are being developed and brought to market. The literature search for this narrative review was performed by searching bibliographic databases (including Google Scholar and PubMed) using the search terms: "Strategies," "Prevention," and "Healthcare-Associated Infections," followed by snowballing references cited by critical articles. We found that although hand hygiene is a centuries-old concept, it is still the primary strategy used around the world to prevent HCAIs. It forms one of a bundle of approaches used to clean and maintain a safe hospital environment and to stop the transmission of contagious and infectious microorganisms, including multidrug-resistant microbes. Finally, antibiotic stewardship also has a crucial role in reducing the impact of HCAIs through conserving currently available antimicrobials.

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Effect of Cessation of Contact Isolation for Endemic Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci

Cited by 14 publications

References 10 publications

Does the removal of contact precautions for MRSA and VRE infected patients change health care-associated infection rate?: A systematic review and meta-analysis

Does the removal of contact precautions for MRSA and VRE infected patients change health care-associated infection rate?: A systematic review and meta-analysis

Epidemiology and risk factors of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci infections in Zhejiang China from 2015 to 2017

<p>Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview</p>

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