Wednesday, February 17, 2016

Contact Precautions: Is the Pendulum Swinging?

In 2012, I co-authored a paper with Dr. Michael Stevens on a framework for discontinuing contact
precautions for endemic MRSA and VRE. 

I highly doubt that anyone read it. 

We then pressed on and successfully discontinued contact precautions at VCU Medical Center and published our results here.

With a group of collaborators from the Society of Healthcare Epidemiology of America, we published an extensive review of contact precautions for the control of endemic MRSA and VRE, once again suggesting that contact precautions may have little benefit as an infection prevention strategy in this situation.

As of late, there has been a relative surge of interest on the topic of contact precautions with this recent publication in Infection Control and Hospital Epidemiology once again calling for robust studies to support the use of contact precautions for MRSA and VRE. This is a huge departure from the 2003 SHEA Guidelines for the control of MRSA and VRE  in which contact precautions was the law of the land.

Before we make something the standard of care and mandatory in infection prevention, we must back it by quality evidence. 

Anything less is subject to dogma and bias and this is not science.