Long-term Impact of Contact Precautions Cessation for Methicillin-Resistant Staphylococcus Aureus (MRSA).

Abstract Background: Methicillin-Resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections (HAI). Contact isolation has been traditionally implemented to stop transmission but its impact is increasingly questioned. Methods: A single center, retrospective, nonrandomized, observational, quasi-experimental study compared MRSA HAI rates between pre-/post discontinuation of MRSA contact isolation in a tertiary university hospital over 68 months. Data on primary outcomes, Central line-associated bloodstream infections (CLABSI) and MRSA LabID bacteremia events, were analyzed by interrupted time series design using segmented Poisson regression modeling. As secondary outcomes catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), surgical site infections (SSI) and hospital-associated pneumonia (HAP) were compared using Fisher's exact tests. Current savings due to discontinuation were calculated based on gown use. Results: 295 patients developed 399 HAIs. Infection rates between pre- and post-interventions were as follows: CLABSI: (0.02% vs. 0.02%; p-value= 0.64), MRSA LabID events: (0.01% vs. 0.02%; p-value= 0.32), HAP: (0.01% vs. 0.01%; p-value=0.64), CAUTI: (0% vs. 0.01%; p-value=0.56), VAP: (0.01% vs. 0.01%; p-value=0.32), SSI (0.55% vs. 0.15%; p-value= 0.03). Savings amount to $139,228 annually. Conclusion: Discontinuing CP did not negatively impact endemic MRSA HAI rates between pre-post discontinuation periods and saved costs for isolation materials.