Report: Contact precautions can help with MRSA, but they don’t need to be essential

Contact precautions, or CP, don’t need to be deemed an “essential practice” to prevent methicillin-resistant Staphylococcus aureus prevention in acute care facilities, according to doctors who recently issued a report on industry guidance.

Even though leading infection control agencies say it is essential to use CP for people who have MRSA, the doctors who published the report said that’s not the case. The report came out on Sept. 21 in Clinical Infectious Diseases. 

Evidence doesn’t show that the recommendation to use CP is always warranted, the authors wrote.

The compendium advocating for broad CP use was published by the Society for Healthcare Epidemiology of America, the Association of Professionals in Infection Control and the Infectious Diseases Society of America.

There aren’t controlled trials to support broad use of CP to prevent MRSA, the authors said. The recommendations don’t prove that CP is better over other interventions such as cleaning and handwashing, they said. For example, there weren’t effects on people getting MRSA when healthcare facilities discontinued CP, the authors stated in their report.

When a long-term care facility requires CP, it can strain physical and human resources. It lowers interactions between healthcare professionals and residents, can extend the length of the stay for the person infected and raise hospital costs, the authors pointed out. 

CP also has negative effects on the environment, because it involves single-use plastics in personal protective equipment such as gowns and gloves, the authors said.

“The burden and harms of CP remain concerning, including the environmental impact of increased gown and glove use,” the authors said. 

It’s difficult to assess the effect of changes in CP use during the pandemic, the doctors who published the report said. That’s because of the differing standards among facilities and the stress on the infection prevention programs, the authors said.

The authors of the report don’t want to do away with CP completely. They suggest that CP should be included in the guidance under “additional approaches” in the recommendations should be enacted under special circumstances, such as outbreaks.