“Bringing Down the Flag”: Removing the Contact Precautions Label for Non-hospitalized Patients with Prior Methicillin-Resistant Staphylococcus aureus Infection or Colonization

2015 ◽  
Vol 36 (5) ◽  
pp. 578-580 ◽  
Author(s):  
Paul J. Carson ◽  
Mallory Danford ◽  
Grace Carson ◽  
Christine Hanish ◽  
Jody Thompson ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Hospitalized Patients ◽  
Methicillin Resistant ◽  
Contact Precautions ◽  
Aureus Infection ◽  
History Of ◽  
Pcr Test

A policy consensus has not been reached regarding discontinuing contact precautions in patients with a history of methicillin-resistant Staphylococcus aureus (MRSA). We found that as many as 72% of outpatients flagged for past MRSA were no longer carriers, and a single nasal PCR test provided a reasonable negative predictive value for removing contact precautions.Infect Control Hosp Epidemiol 2015;00(0): 1–3

scholarly journals Resource Burden Associated with Contact Precautions for Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus: The Patient Access Managers' Perspective

2012 ◽  
Vol 33 (8) ◽  
pp. 849-852 ◽  
Author(s):  
Erica S. Shenoy ◽  
Rochelle P. Walensky ◽  
Hang Lee ◽  
Benjamin Orcutt ◽  
David C. Hooper
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Vancomycin Resistant Enterococcus ◽  
Patient Access ◽  
Methicillin Resistant ◽  
Contact Precautions ◽  
Factors Influencing ◽  
History Of ◽  
Vancomycin Resistant ◽  
The Impact

We surveyed patient access managers on the impact of contact precautions (CP) for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE) on time to bed assignment, and we investigated the factors influencing infection control policies allowing for discontinuation of CP. The majority of respondents reported an increase in time to bed assignment for patients with a history of MRSA and/or VRE infection or colonization.

scholarly journals 247. The Predictive Value of Methicillin-Resistant Staphylococcus aureus Surveillance Swabs in Septic Arthritis

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S231-S232
Author(s):  
Samuel Harder ◽  
Kwame Asiamah ◽  
Geoffrey Shumilak ◽  
Beverly J Wudel
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Positive Predictive Value ◽  
Septic Arthritis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Causative Pathogen ◽  
Methicillin Resistant ◽  
Rule Out

Abstract Background Septic arthritis is a destructive form of acute arthritis secondary to infection. With an annual incidence of 2 to 5 cases per 100 000 individuals, it is associated with significant morbidity and mortality. Prompt source control and antimicrobial therapy remain the mainstays of management. Epidemiology, microbiology studies, and local resistance patterns are important in guiding therapeutic decisions. Staphylococcal and streptococcal species are the most common pathogens with Methicillin-resistant Staphylococcus aureus (MRSA) becoming an increasingly important pathogen. The increasing incidence of MRSA provides clinicians with the challenge of deciding which patients require empiric coverage for MRSA. MRSA nasal screening has been shown to have a high negative predictive value in pneumonia, bloodstream infections, and nosocomial infections in critically ill patients. However, little is known about the diagnostic utility of MRSA surveillance swabs for predicting MRSA infections in septic arthritis. Methods A retrospective cohort study was performed in 3 tertiary hospitals from September 1, 2010 to December 31, 2020. All adult patients with confirmed septic arthritis of the ankle, wrist, knee, or hip and an MRSA surveillance swab performed within 72 hours of admission were included in the study. These data were used to calculate the sensitivity, specificity, positive predictive value and negative predictive value for MRSA surveillance swabs. Results One hundred seventy-two patients met inclusion criteria. Thirty patients had positive MRSA surveillance swabs. The prevalence of MRSA in joint cultures was 11.04%. The positive predictive value of MRSA surveillance swabs was 42.3% and the negative predictive value was 93.5% in all participants. The MRSA surveillance swab had a negative predictive value of 100% in participants with no risk factors for MRSA colonization. Conclusion The negative predictive value of MRSA surveillance swabs used independently is insufficient to confidently rule out MRSA as the causative pathogen in septic arthritis. When used in combination with MRSA risk factors, the absence of MRSA risk factors may help clinicians rule out MRSA as a causative pathogen. Disclosures All Authors: No reported disclosures

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