Impact of discontinuation of contact precautions on central-line associated bloodstream infections in an academic children’s hospital

Abstract

We investigated the impact of discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus infected or colonized patients on central-line associated bloodstream infection rates at an academic children’s hospital. Discontinuation of contact precautions with a bundled horizontal infection prevention platform resulted in no adverse impact on CLABSI rates.

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

“…Although our results are similar to Marra et al; it is important to note that our systematic review and meta-analysis is the most updated to this date on this topic and includes 6 additional studies compared with meta-analysis by Marra et al 6 These 6 additional articles addressed rates of infection with and without CP implementation as well. 12,13,17,20,24,27 Three of these studies found no statistical significance amongst rates of hospital-associated MRSA HAI and favored discontinuation of CP use. 12,13,24 Trick et al additionally compared rates of infection in hospital-associated VRE HAI and also found no statistical significance, favoring discontinuation of CP use.…”

“…Characteristics of the included studies are summarized in Table 1. 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.…”

“…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. Two studies were prospective observational studies comparing 2 tertiary care medical centers or 2 similar sections of one hospital.…”

“…Similarly, the studies by Fazal et al 15 and Watkins et al 25 did not report data (incidence rate) that was conducive for meta-analysis. In addition, the data from study by Godbout et al 17 was not included in the metaanalysis as they did not report HAI rate for MRSA and VRE separately.…”

The learning hospital: From theory to practice in a hospital infection prevention program

“…• Impact of discontinuation of contact precautions on central-line associated bloodstream infections in an academic children's hospital -Godbout et al 32 • Control of drug-resistant pathogens in endemic settings: contact precautions, controversies, and a proposal for a less restrictive alternative -Bearman et al 33 • Impact of discontinuing contact precautions for mrsa and vre: an interrupted time series analysis -Bearman et al 19 • Duration of contact precautions in acute-care settings -Banach et al 34 • Contact precautions for multi-drug resistant organisms-reply -Morgan et al 35 • Contact precautions for endemic MRSA and VRE: time to retire legal mandates -Morgan et al 36 • Reconsidering contact precautions for endemic MRSA and VRE -Morgan et al 37 • Effect of contact precautions on wait time from emergency room disposition to inpatient admission -McLemore et al 38 • The impact of discontinuing contact precautions for VRE and MRS on device-associated infections -Edmond et al 39 • With a robust horizontal infection prevention platform, CP had no impact on device-associated HAI rates in adults or CLABSIs in children. • Critical assessment of CP for endemic pathogens resulted in significant institutional policy and practice change.…”