Highlights
- •We reviewed the literature on the effectiveness and adverse effects of contact precautions to decrease methicillin-resistant Staphylococcus aureus.
- •Contact precautions did not reduce transmission of methicillin-resistant Staphylococcus aureus in nonepidemic settings.
- •Contact precautions were associated with both decreased health care providers' time spent with patients and low compliance.
- •Patients on contact precautions had more negative psychologic implications.
Background
Contact precautions (CPs) are recommended to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission in institutions. Rising doubts about CP effectiveness and recognition
of unintended consequences for patients have raised questions about the benefit. The
objective of this study was to evaluate the effectiveness and adverse outcomes associated
with CPs for prevention of MRSA transmission.
Methods
We searched PubMed, Embase, and the Cochrane Library for articles related to effectiveness
and adverse outcomes of CPs in patients with MRSA. Criteria for inclusion included
the following: articles conducted in the United States, articles performed in an acute
care setting, articles that were not a case series or review, and those with standardized
collection of data or inclusion of case and control groups. Results were summarized
and examined for potential limitations. Recommendations were based on our findings.
Results
CPs reduced MRSA transmission in epidemic settings and in instances with high compliance,
but a decrease in infection rates was not shown. Unintended consequences of CPs include
decreased health care provider (HCP) time spent with patients, low HCP compliance,
decreased perceptions of comfort from patients, and greater likelihood of patient
complaints and negative psychologic implications.
Conclusion
In endemic settings, there are few data to support routine use of CPs to control the
spread of MRSA. Education should be performed in hospitals to improve patients' perception
of care and understanding of CPs when implemented and HCPs' adherence to good hand
hygiene and standard precautions practices.
Key Words
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Article Info
Publication History
Published online: September 12, 2015
Footnotes
Conflicts of interest: At time of writing, Kullar was employed by Cubist Pharmaceuticals and owns Cubist Pharmaceuticals stock; the views expressed here are her own and not necessarily those of Cubist Pharmaceuticals. The other authors have nothing to disclose.
Identification
Copyright
Published by Elsevier Inc.
