Effect of contact precautions on preventing meticillin-resistant Staphylococcus aureus transmission in intensive care units: a review and modelling study of field trials

J Hosp Infect. 2024 Feb:144:66-74. doi: 10.1016/j.jhin.2023.09.023. Epub 2023 Nov 28.

Abstract

Background: Contact precautions (CPs) have been widely implemented in hospitals, particularly in intensive care units (ICUs), as the standard approach for managing meticillin-resistant Staphylococcus aureus (MRSA). However, the effectiveness of CPs in preventing MRSA transmission remains a subject of debate.

Aim: To assess the effectiveness of CPs in reducing MRSA transmission within ICUs.

Methods: A comprehensive analysis was conducted using data from 16 sets of parameters collected from 13 field studies investigating the effectiveness of CPs in ICUs, and an epidemiologic model was developed to simulate the dynamics of MRSA incidence in the hospital setting.

Findings: The analysis demonstrated a mean reduction of 20.52% (95% confidence interval -30.52 to 71.60%) in the MRSA transmission rate associated with the implementation of CPs. Furthermore, reducing the time-delay of screening tests and increasing the percentage of patients identified with MRSA through screening at admission were found to contribute to the effectiveness of CPs.

Conclusion: Proper implementation of CPs, with a particular emphasis on early identification of MRSA-colonized/infected patients, demonstrated a strong association with reduced MRSA transmission within the hospital setting. However, further research is necessary to investigate the effectiveness and safety of decolonization and other interventions used in conjunction with CPs to mitigate the risk of infection among colonized patients.

Keywords: CPs; ICU; MRSA; Modelling; Nosocomially acquired colonization.

Publication types

  • Review

MeSH terms

  • Cross Infection* / epidemiology
  • Humans
  • Intensive Care Units
  • Methicillin
  • Methicillin-Resistant Staphylococcus aureus*
  • Staphylococcal Infections* / epidemiology
  • Staphylococcal Infections* / prevention & control

Substances

  • Methicillin