Disclosures: Khader reports receiving grants from the CDC during the conduct of this study. Please see the study for all other authors’ relevant financial disclosures.
April 11, 2021
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Contact precautions reduce MRSA transmission by almost 50% in VA hospitals

Disclosures: Khader reports receiving grants from the CDC during the conduct of this study. Please see the study for all other authors’ relevant financial disclosures.
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Researchers estimated that contact precautions were associated with a nearly 50% reduction in the MRSA transmission rate among adult patients in more than 100 Veterans Affairs hospitals, according to a study published in JAMA Network Open.

“[This] should lead to a reduction in the number of MRSA infections, many of which will occur after the patients’ hospitalizations,” Karim Khader, PhD, MStat, MS, research assistant professor of epidemiology at the University of Utah School of Medicine, told Healio. “Contact precautions combined with universal surveillance is an effective measure for reducing transmission of MRSA.”

Karim Khader pullquote

Khader and colleagues developed mathematical models to estimate the association between contact precautions and MRSA transmission among more than 2 million patients at 108 Veterans Affairs (VA) hospitals. The models “incorporate the epidemiology of MRSA transmission to estimate the underlying transmission rate,” they explained.

Among the patients in the study, there were more than 5.6 million admissions — 14.1% of which “were presumed to have contact precautions with more than 8.4 million MRSA surveillance tests,” the researchers wrote.

According to the study, between 2008 and 2017, reductions in MRSA transmission ranged from 43% (95% credible interval [CrI], 38%-48%) to 51% (95% CrI, 46%-55%). Overall, Khader and colleagues estimated that contact precautions reduced MRSA transmission by 47% (95% CrI, 45%-49%).

Bigger facilities (RR = 0.84; 95% CI, 0.74-0.96) and facilities with higher admission screen compliance (RR = 0.74; 95% CI, 0.58-0.96) experienced larger reductions in transmission associated with contact precautions than smaller facilities and facilities with low screening compliance.

Khader said the study’s limitations included an inability to obtain information on compliance with contact precautions.

“There are other factors that may influence transmission of MRSA in addition to contact precautions, including use of antibiotics, which were not explicitly accounted for in this study,” Khader said. “This limitation could be addressed in a future analysis by expanding our underlying model to incorporate additional patient care factors that may also associated with changes in transmission of MRSA.”