Since local factors can be dominant in infection prevention (e.g. size of hospital, number of ICUs or prevalence of MRSA on admission) it is important to acknowledge that one size doesn't always fit all, as far as use of Contact Precautions for MDRO control. At the 2012 APIC meeting in San Antonio Maureen Hodson, RN CIC, at HealthAlliance Hospital in Massachusetts presented her hospital's experience with shifting towards a stronger emphasis on Standard Precautions and away from Contact Precautions. Contact Precautions were limited to MRSA and VRE patients who present with uncontained secretions and ESBL, MDR-GNR and active C. difficile patients.
When comparing the 4-month intervention period to prior periods, costs for gowns and gloves declined by $20,000 and VRE infections declined while MRSA infections were unchanged (see table below). It will be nice to see if this can be sustained and what the impact is on ESBL or C. difficile, but this approach makes a lot of sense.
Reference: Hodson et al, oral presentation #117, APIC 2012