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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Duration of infection control precautions for acute care settings

Duration of infection control precautions for acute care settings
Pathogen Guidance for precaution discontinuation Reference
Methicillin-resistant Staphylococcus aureus (MRSA)

Following completion of antibiotic therapy as needed, contact precautions may be discontinued after documentation of 1 to 3 negative weekly surveillance cultures.*

Extension of contact precautions may be warranted for patients with a draining wound, ongoing respiratory secretions associated with MRSA infection, or other evidence implicating risk of ongoing transmission.		 [1,6]
Vancomycin-resistant enterococcus (VRE)

Following completion of antibiotic therapy as needed, contact precautions may be discontinued after documentation of 1 to 3 negative weekly stool or rectal swab surveillance cultures.*

Extension of contact precautions may be warranted for patients who are highly immunosuppressed, are receiving broad-spectrum antibiotic therapy (without VRE activity), or receiving care in protected environments (such as burn units) or in institutions with high VRE rates.		 [1,6]
Clostridioides difficile Continue contact precautions for at least 48 hours after resolution of diarrhea. Since persistent shedding of spores is common[3], extension of contact precautions beyond resolution of diarrhea (eg, for remainder of hospitalization) is warranted in some situations, such as for incontinent patients. [1,3]
Multi-drug resistant gram-negative (MDR-GN) pathogens
Extended-spectrum beta-lactamase (ESBL) and other MDR-GN pathogens Continue precautions for duration of hospitalization. Guidelines recommend assessing discontinuation of precautions on a case-by-case basis related to time since onset of infection, need for ongoing antibiotic use, negative rectal screening samples, and specific pathogen (as an example, transmission risk of ESBL-positive Escherichia coli may be relatively limited). [1]
Carbapenem-resistant enterobacteriaceae (CRE) and Extremely drug-resistant gram negative (XDR-GN) pathogens Maintain as long as patients are hospitalized or in a congregate living setting. [1]
Influenza In immunocompetent hosts, the duration of droplet precautions is 7 days after illness onset or until 24 hours after resolution of fever and respiratory symptoms, whichever is longer. The optimal duration for immunocompromised hosts is uncertain. [2]
Varicella zoster virus (VZV) infection
Localized zoster Airborne and contact precautions should be continued until lesions are dry and crusted. For immunocompetent patients whose lesions can be covered, standard precautions are sufficient if health care provider(s) are immune. [4,5]
Disseminated zoster Airborne and contact precautions should be continued until lesions are dry and crusted. [4,5]
Herpes simplex virus (HSV) infection Contact precautions should be continued until lesions are dry and crusted. [4]
* If the screening culture is performed within a year of the infection, most institutions require 3 negative cultures (off of antibiotics). If the screening culture is performed more than 1 year after resolution of the infection, most institutions require 1 negative culture (off of antibiotics).[1,5]
References:
  1. Banach DB, Bearman G, Barnden M, et al. Duration of contact precautions for acute-care settings. Infect Control Hosp Epidemiol 2018; 39:127.
  2. Centers for Disease Control and Prevention. Prevention strategies for seasonal influenza in healthcare settings. http://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm (Accessed on April 8, 2019).
  3. Bobulsky GS, Al-Nassir WN, Riggs MM, et al. Clostridium difficile skin contamination in patients with C. difficile-associated disease. Clin Infect Dis 2008; 46:447.
  4. Siegel JD, Rhinehart E, Jackson M, et al. 2007 guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control 2007; 35:S65.
  5. United States Centers for Disease Control and Prevention. Preventing varicella-zoster virus (VZV) transmission from zoster in healthcare settings. https://www.cdc.gov/shingles/hcp/hc-settings.html (Accessed on April 8, 2019).
  6. Huckabee CM, Huskins WC, Murray PR. Predicting clearance of colonization with vancomycin-resistant Enterococci and methicillin-resistant Staphylococcus aureus by use of weekly surveillance cultures. J Clin Microbiol 2009; 47:1229.
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