![]() Contact Precautions should be used for patients known or suspected to have serious illnesses easily transmitted by direct patient contact or by contact with items in the patient’s environment, such as gastrointestinal, respiratory, skin, or wound infections or colonization with multidrug-resistant organisms of epidemiologic significance such as Clostridium difficile. Airborne Precautions should be used for patients known or suspected to have serious illnesses transmitted by airborne droplet nuclei, including measles, tuberculosis, and varicella.ĭroplet Precautions should be implemented for patients known or suspected to have serious illnesses transmitted by large particle droplets, including Haemophilus influenzae Type B disease, including meningitis, pneumonia, epiglottitis, and sepsis, as well as bacterial respiratory infections such as diphtheria, pertussis, pneumonic plague Streptococcal (group A) infections, influenza, mumps, and rubella. 3 In addition to Standard Precautions, one of the three types of precautions relating to the route of transmission should be employed. In order for them to work as designed, the most appropriate precautions must be matched to the patient properly. Although no single approach to dealing with MRSA in HCWs will work universally, aggressive screening and eradication policies seem justified in outbreak investigations or when MRSA has not reached endemic levels.” Thus, good hand hygiene practices remain essential to control the spread of MRSA. Harbarth and Albrich note, “HCWs are likely to be important in the transmission of MRSA, most frequently acting as vectors and not as the main sources of MRSA transmission. While the time commitment and expense associated with pre-employment and periodical screening of HCWs for MRSA might be challenging for some healthcare facilities, some experts believe that routine surveillance of HCWs during the first stages of an outbreak is prudent, especially in high-risk areas such as surgical intensive care units and burn units. The authors note, “Poor infection control practices were implicated in both acquisition and transmission of MRSA by personnel, but even good adherence to infection control - including masks and hand hygiene - did not entirely prevent transmission of MRSA from heavily colonized staff to patients.” They found that about 6 percent of HCWs were colonized with MRSA, while about 5 percent had active MRSA infections. Stephan Harbarth of the University Hospitals in Geneva, Switzerland, and Werner Albrich, of the University of the Witwatersand in Johannesburg, South Africa, scrutinized data from approximately169 studies that examined more than 33,000 HCWs from 37 countries. A new comprehensive review of data from more than 160 studies suggests that hospitals could do a better job of screening healthcare workers for methicillin-resistant Staphylococcus aureus (MRSA) infections. Transmission-based precautions are more critical than ever before, especially as the virulence and resistance of superbugs increase and data continue to indicate that HCWs are hosts and carriers of infectious diseases because of colonization or active infection. ![]() ![]() ![]() The isolation guidelines issued by the Centers for Disease Control and Prevention (CDC) in 1996 created a two-tiered approach: Standard Precautions and Transmission-Based Precautions, 1 which draw from protocols established in Universal Precautions (UP) and Body Substance Isolation (BSI) Precautions. Every infection involves three components: a reservoir of microorganisms (i.e., contaminated hands or inanimate surfaces), a susceptible host (i.e., patients, visitors or healthcare workers ), and a mechanism of transmission, which refers to the three routes of transmission - airborne, droplet and contact. ![]() The prevention of the transmission of pathogens goes to the heart of every evidence-based intervention used to control and eliminate hospital-acquired infections (HAIs). ![]()
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