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Barrier Precautions in the Era of Multidrug Pathogens.


ABSTRACT: Purpose of review:There is a continuing debate regarding contact precaution (CP) usage for endemic multidrug-resistant organisms (MDROs). In this review, we examine current recommendations for CP and highlight differences in CP use between endemic and non-endemic MDROs. Recent findings:The discontinuation of CP had no effect on the incidence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci. The evidence regarding CP for extended-spectrum beta-lactamase producing Enterobacteriaceae is inconclusive, highlighting the need for more research to determine best infection control strategies. Carbapenem-resistant Enterobacteriaceae maintains a sporadic pattern in the USA, supporting current recommendations to use CP for colonized and infected patients. MDR Acinetobacter baumannii (MDR-AB) is extremely virulent and responsible for outbreaks in healthcare settings, emphasizing the need for CP use with MDR-AB infected patients. Candida auris (C. auris) is often misdiagnosed; it is resistant to UV light and quaternary ammonium low-level disinfection. Because little is known about the transmission of C. auris, significant caution and CP use are necessitated. There is little research on vancomycin-resistant S. aureus (VRSA) control strategies due to its rarity; thus, CP is strongly recommended. Summary:Contact precautions are frequently part of a bundled infection control approach that involves meticulous hand hygiene, patient decolonization, chlorhexidine gluconate bathing, and reducing the use of invasive devices. Healthcare facilities should continue to utilize CP for non-endemic MDROs and the presence of endemic MDROs; however, CP may not add benefit to the current infection prevention bundle approach.

SUBMITTER: Pryor R 

PROVIDER: S-EPMC7323884 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Barrier Precautions in the Era of Multidrug Pathogens.

Pryor Rachel R   Viola-Luqa Carli C   Hess Olivia O   Bearman Gonzalo G  

Current treatment options in infectious diseases 20200629 3


<h4>Purpose of review</h4>There is a continuing debate regarding contact precaution (CP) usage for endemic multidrug-resistant organisms (MDROs). In this review, we examine current recommendations for CP and highlight differences in CP use between endemic and non-endemic MDROs.<h4>Recent findings</h4>The discontinuation of CP had no effect on the incidence of methicillin-resistant <i>Staphylococcus aureus</i> and vancomycin-resistant <i>Enterococci</i>. The evidence regarding CP for extended-spe  ...[more]

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