Daniel J Morgan1,2, Min Zhan1,2, Michihiko Goto3,4, Carrie Franciscus4, Bruce Alexander4, Mary Vaughan-Sarrazin3,5, Mary-Claire Roghmann1,2, Lisa Pineles1,2. 1. Veterans Affairs Maryland Health Care System, Baltimore, Maryland, USA. 2. Department of Epidemiology and Public Health, Division of Genomic Epidemiology & Clinical Outcomes, Baltimore, Maryland, USA. 3. Department of Internal Medicine, Division of Infectious Diseases, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA. 4. Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa, USA. 5. Department of Internal Medicine, Division of General Internal Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA.
Abstract
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of health care-associated infections in long-term care facilities (LTCFs). The Centers for Disease Control and Prevention recommends contact precautions for the prevention of MRSA within acute care facilities, which are being used within the United States Department of Veterans Affairs (VA) for LTCFs in a modified fashion. The impact of contact precautions in long-term care is unknown. METHODS: To evaluate whether contact precautions decreased MRSA acquisition in LTCFs, compared to standard precautions, we performed a retrospective effectiveness study (pre-post, with concurrent controls) using data from the VA health-care system from 1 January 2011 until 31 December 2015, 2 years before and after a 2013 policy recommending a more aggressive form of contact precautions. RESULTS: Across 75 414 patient admissions from 74 long-term care facilities in the United States, the overall unadjusted rate of MRSA acquisition was 2.6/1000 patient days. Patients were no more likely to acquire MRSA if they were cared for using standard precautions versus contact precautions in a multivariable, discrete time survival analysis, controlling for patient demographics, risk factors, and year of admission (odds ratio, 0.97; 95% confidence interval, .85-1.12; P = .71). CONCLUSIONS: MRSA acquisition and infections were not impacted by the use of active surveillance and contact precautions in LTCFs in the VA. Published by Oxford University Press for the Infectious Diseases Society of America 2019.
BACKGROUND:Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of health care-associated infections in long-term care facilities (LTCFs). The Centers for Disease Control and Prevention recommends contact precautions for the prevention of MRSA within acute care facilities, which are being used within the United States Department of Veterans Affairs (VA) for LTCFs in a modified fashion. The impact of contact precautions in long-term care is unknown. METHODS: To evaluate whether contact precautions decreased MRSA acquisition in LTCFs, compared to standard precautions, we performed a retrospective effectiveness study (pre-post, with concurrent controls) using data from the VA health-care system from 1 January 2011 until 31 December 2015, 2 years before and after a 2013 policy recommending a more aggressive form of contact precautions. RESULTS: Across 75 414 patient admissions from 74 long-term care facilities in the United States, the overall unadjusted rate of MRSA acquisition was 2.6/1000 patient days. Patients were no more likely to acquire MRSA if they were cared for using standard precautions versus contact precautions in a multivariable, discrete time survival analysis, controlling for patient demographics, risk factors, and year of admission (odds ratio, 0.97; 95% confidence interval, .85-1.12; P = .71). CONCLUSIONS: MRSA acquisition and infections were not impacted by the use of active surveillance and contact precautions in LTCFs in the VA. Published by Oxford University Press for the Infectious Diseases Society of America 2019.
Entities:
Keywords:
MRSA; contact precautions; infection; long-term care
Authors: Valerie Wing Yu Wong; Ying Huang; Wan In Wei; Samuel Yeung Shan Wong; Kin On Kwok Journal: Antimicrob Resist Infect Control Date: 2022-01-15 Impact factor: 4.887