bacterial infections

SHEA: New Guidelines for C. Difficile, Drug-Resistant Infections

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.
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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 Enterobacteriaceae and extended-spectrum beta-lactamase-producing organisms are detected.

 

For the full version of the new SHEA guidelines, click here.

—Christina Vogt

Reference:

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.