I get that no one likes to don gowns and gloves before seeing patients, particularly ID consultants who see a large number of patients colonized/infected with MDROs. I understand that touching is important for healing and that somehow wearing gloves impedes the healing touch. I even see why some still think that contact precautions place patients at greater risk for medical errors, even if the data supporting that contention is lacking. What I don't get is why infection prevention folks are pillorying one of the most effective methods we have in MDRO transmission prevention right when we need it the most.
1) MDRO rates, particularly for Gram-negative pathogens like CRE and Acinetobacter are increasing
2) We have no antibiotics in our quiver, so prevention is our only hope for a decade+
3) Most prior room occupant studies are flawed and when proper methods are used, prior room occupants are not a risk factor - thus the environment isn't the only answer.
4) Hand hygiene compliance is only 60% - I know some are claiming 90%+ on their reports, but it's simply not true.
5) Gloves are massively effective in reducing the burden of organisms on hands and CP have now been shown to be effective in an RCT - (if you can look past the JAMA trial nihilists)
Which brings me to the table below modified from a study we completed a few years ago. You'll notice the red circle highlighting the per room entry contamination rate of healthcare workers hands with A. baumannii when hand hygiene compliance is 60%. The green circle highlights the contamination rate when gloves are worn with the 90% compliance achieved in the BUGG study (even ignoring that universal CP is associated with higher HH compliance). You can see that when a healthcare worker enters an A. baumannii+ patient's room, 15% of the time they will leave the room with A. baumannii on their hands. If the hospital practices universal CP, it will be 3% of the time.
So, I get why people hate contact precautions, particularly ID-trained hospital epidemiologists. I just don't get the delight with which they limit their use given that CP are supported by the strongest evidence that our dismal science can muster. I suspect, again, that I won't have to live that long to witness their regret.