The Society for Healthcare Epidemiology of America (SHEA) has released new guidelines regarding the appropriate duration of contact precautions for the treatment of multi-drug-resistant infections and Clostridium difficile (C. difficile) in acute-care hospitals.
The new guidelines were formed by experts on the SHEA Guidelines Committee based on available evidence, theoretical rationale, practical considerations, a survey of SHEA members, author opinion, and consideration of potential harm.
The following recommendations are included in the new guidelines:
• For patients with C. difficile, contact precautions should be followed for at least 48 hours after the resolution of diarrhea.
• For individuals with methicillin-resistant Staphylococcus aureus (MRSA) who are not treated with an anti-MRSA antibiotic, 1 to 3 negative cultures should be obtained prior to discontinuing contact precautions.
• Following treatment of patients with vancomycin-resistant Enterococci, 1 to 3 negative cultures should be obtained prior to discontinuing contact precautions. If more than 1 culture is needed, they should be obtained 1 week apart.
• For patients with multidrug-resistant Enterobacteriaceae, contact precautions should remain in place throughout hospitalization as soon as carbapenem-resistant Enterob-acteriaceae and extended-spectrum beta-lactamase-producing organisms are detected.
Banach DB, Bearman G, Barnden M, et al. Duration of contact precautions for acute-care settings [Published online January 11, 2018]. Infect Control Hosp Epidemiol.https://doi.org/10.1017/ice.2017.245.