2186. High Adherence to Contact Precautions of Patients with Multidrug-resistant Organisms (MDRO) and Low In-Hospital Transmission of MDROs

Abstract

BackgroundConflicting results have been published on the impact of contact precautions, as outlined by CDC, HIPAC and ESCMID guidelines, on reduction of transmission of multidrug-resistant organisms (MDRO). Ambiguous definitions coupled with low adherence to these partly explain the differences on impact of contact precautions on transmission of MDROs. We therefore monitored compliance with contact precautions and correlated the level of adherence with in-hospital transmission of MDROs.MethodsBetween January 2016 and March 2018, all patients under contact precautions underwent routine monitoring of adherence to contact precautions by routine on site visits on day 0 (+1), 3 (+/−1) and 7(+/−3) after initiating of contact precautions using a predefined standardized checklist. The protocol includes 10 interventions that are routinely checked such as contact precaution sign at the door and wearing gowns and gloves before entering the room. Patients requiring contact precautions were defined as colonized or infected with MDROs (MRSA, non-E. coli ESBL-Enterobacteriaceae (NEC-ESBL), VRE and carbapenemase-producing organisms) as well as patients infected with RSV, norovirus and hypervirulent strains of C. difficile.ResultsOverall, data of 1,414 visits of 812 patients under contact precautions were assessed. During the observation period, overall adherence was between 93–99% for each intervention, except for separate space for contaminated material with a very low adherence between 5.4 and 6.1%. The incidence of in-hospital transmission was extremely low for MRSA, VRE and NEC-ESBL with 0.02–0.1/100,000 patient days.ConclusionContinuous monitoring of the quality of contact precautions showed excellent overall adherence correlating with a very low in-hospital transmission of MDROs, encouraging monitoring as an integrated part of contact precautions.Disclosures All authors: No reported disclosures.