Contact Precautions for MRSA Wound Infections

Rationale and Implementation

The World Health Organization recommends contact precautions for patients with MRSA wound infections to prevent transmission in healthcare settings 1, 2
Contact precautions are considered an essential practice for patients known to be infected with MRSA in acute care facilities, particularly for wounds that are draining or not fully contained by dressings 1, 3
Implementation should include placing patients in a single room or cohorting with other MRSA-positive patients, and healthcare workers must wear gowns and gloves when entering the patient's room or before contact with the patient 4
Removal of gloves and gown before leaving the patient's room, followed by immediate hand washing with an antiseptic soap or waterless antiseptic agent, is also recommended 3

The Centers for Disease Control and Prevention recommends dedicating non-critical medical equipment to the patient or cohort of patients with MRSA, and ensuring proper cleaning and disinfection between patients 3
Keeping draining wounds covered with clean, dry bandages at all times, and maintaining good environmental hygiene with focus on high-touch surfaces in the patient's room, is also crucial 5
Screening roommates of newly identified MRSA patients to determine colonization status is an important measure to prevent transmission 3

Contact precautions should be maintained throughout the hospital stay unless specific criteria for discontinuation are met, such as multiple negative cultures (at least three consecutive negative results from multiple body sites including wounds, taken at least one week apart) 3
Establishing a system to flag medical records of MRSA-positive patients for prompt identification upon readmission is also recommended 3

In settings with ongoing MRSA transmission despite basic precautions, consider cohorting staff to minimize contact between MRSA-positive and MRSA-negative patients, and active surveillance cultures to identify MRSA carriers more rapidly 3, 4
Decolonization strategies for patients with recurrent MRSA infections may also be considered 5

The American Academy of Infectious Diseases recommends providing preventive educational messages on personal hygiene and appropriate wound care, including keeping draining wounds covered with clean, dry bandages, and maintaining good personal hygiene with regular bathing and hand cleaning 5