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contact precautions

Avoids spread of infection via direct or indirect contact. Includes drainage & secretion precautions & enteric precautions. Examples: 1) Clostridium difficile - duration: at least 48 hours after diarrhea resolves [3] 2) respiratory syncytial virus (RSV) 3) impetigo & other forms of a) Staphylococcus aureus including MRSA - duration for patients not receiving an antibiotic active against MRSA, 1-3 negative cultures before discontinuing [3] b) Streptococcus pyogenes 4) scabies 5) vancomycin-resistant enterococci - 1-3 negative cultures before discontinuing - cultures should be 1 week apart [3] 6) extended-spectrum beta-lactamase resistant gram negative bacteria & multidrug-resistant Enterobacteriaceae*: - throughout hospitalization after 1st detected [3] 7) rotavirus 8) varicella-zoster (also airborne precautions) * includes carbapenem-resistant Enterobacteriaceae Methods: 1) private room 2) use of gloves & gowns 3) eye protection & masks if potential for splash 4) hand washing (single most important measure) 5) alcohol-based hand-rubs if hands not visibly soiled 5) dedicated medical items a) stethoscopes b) thermometers c) blood pressure cuffs Notes: - overall compliance with contact precautions is low & decreases as the proportion of patients in contact precautions increases

Related

infection control universal precautions

General

standard precautions

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18. American College of Physicians, Philadelphia 1998, 2012, 2015, 2018. - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  2. Dhar S et al. Contact precautions: More is not necessarily better. Infect Control Hosp Epidemiol 2014 Mar; 35:213. PMID: 24521583 - Anderson DJ et al. On contact precautions: The good, the bad, and the ugly. Infect Control Hosp Epidemiol 2014 Mar; 35:222 PMID: 24521584
  3. Banach DB, Bearman G, Barnden M et al Duration of Contact Precautions for Acute-Care Settings. Infection Control & Hospital Epidemiology. Jan 11, 2018 PMID: 29321078 https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/duration-of-contact-precautions-for-acutecare-settings/94E38FDCE6E1823BD613ABE4E8CB5E56