Safety of discontinuation of contact precautions in patients with multidrug resistant bacteria infection or colonization
AIM: To identify the safety of an institutional protocol to discontinue contact precautions (CP) in patients with multidrug-resistant bacteria (MDRB) infection/colonization. BACKGROUND: CP are critical in preventing MDRB spread in hospitals. However, information when to discontinue CP is lacking whi...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716524003072 |
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| Summary: | AIM: To identify the safety of an institutional protocol to discontinue contact precautions (CP) in patients with multidrug-resistant bacteria (MDRB) infection/colonization. BACKGROUND: CP are critical in preventing MDRB spread in hospitals. However, information when to discontinue CP is lacking which can result with pro-longed isolation with compliance problems in heavy health-care setting. METHODS: Eighty-eight patients >18-years with carbapenem-resistant Enterobacterales (CRE) (n=50), methicillin-resistant Staphylococcus aureus (n=30) and vancomycin-resistant Enterococcus (n=8) in whom CP were discontinued according to local protocol between 2018 and 2023 were analysed, retrospectively. The primary outcome was the rate of acquisition of the same MDRB up to one year. RESULTS: Seventy (79.5%) out of 88 patients did not acquiesce with the same MDRB. Eighteen (20.5%) patients acquiesced the same MDRB in median 105 days (IQR, 13.5-231). The rates of COPD, consumption of antibiotics active against the MDRB, and central venous catheterisations in the previous month were higher in patients who acquiesced the same MDRB (Table 1). Consumption antibiotics in the past month, increase in number of hospitalisations longer than 72 hours within 6 months, central venous catheterisation in the past month, and presence of COPD were the risk factors for acquisition of the same MDRB in the multivariate logistic regression model (Table 2). CONCLUSIONS: The institutional protocol has been found to be safe to discontinue CP. However, patients with previous history of MDRB infection/colonization in whom CP were discontinued should be followed closely and screened regularly in case of introduction of risk factors for MDRB infection/colonization. |
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| ISSN: | 2213-7165 |