Contact precautions are an important component of our interventions to reduce the transmission of MDRO’s (multi-drug-resistant organisms) and other potentially contagious diseases in hospitals. But contact precautions, in particular contact isolation, are not without potential downsides. We’ve done several columns (listed below) on the unintended consequences of contact isolation.
The SHEA (Society for Healthcare Epidemiology of America) expert guidance on duration of contact precautions for acute care settings was recently published (Banach 2018). Most prior guidelines for contact precautions for MDRO’s (multi-drug-resistant organisms) have addressed when to use such precautions but have paid less attention to how long such precautions should be used.
SHEA notes that expert guidance documents are developed to address areas of relatively narrow scope that lack the level of evidence required for a formal guideline but are important for the provision of safe and effective healthcare.
The SHEA guidance provides recommendations regarding discontinuation of contact precautions (CP) at the individual patient level in acute-care hospitals employing CP for the following organisms:
You’ll have to go to the actual SHEA document for details of the recommendations for each organism. The guidance also has good discussion about sites of colonization and groups at risk for prolonged colonization and discussion about microbiology testing, including molecular testing.
Some of our prior columns on the unintended consequences of contact isolation:
Banach D, Bearman G, Barnden M, et al. Duration of Contact Precautions for Acute-Care Settings. Infection Control & Hospital Epidemiology 2018; 1-18. Published online: 11 January 2018