1. Contact precautions.
Contact precautions (CP) consist in applying the following measures:
use dedicated equipment (blood pressure cuff, thermometer, and stethoscope);
put on gown and gloves before entry to the patient’s room;
change gloves immediately if visibly soiled, and after touching or handling surfaces or materials contaminated with faeces;
remove gown and gloves before exiting the room;
if cohorting is used, change the gown and gloves and perform hand hygiene after caring for one patient and prior to providing care for the next patient;
routinely check available supplies for contact precautions to ensure that adequate selection and amounts are readily available.
There is no study focused on the use of surgical masks as a component of CP in the management of patients with respiratory colonization or infection due to MDR-Gram-negative bacteria. A few papers reporting outbreaks due to MDR-A. baumannii added masks on the top of CP in the ICU settings with favourable results. However, the low quality of evidence and the heterogeneity of case-mix of patients do not support generalizing this intervention .
In the SHEA guideline for preventing nosocomial transmission of MDR S. aureus and Enterococcus it was recommended to wear masks as part of isolation precautions when entering the room of a patient colonized or infected with MRSA to decrease nasal acquisition by HCWs. However this issue has not been studied adequately .
Original contribution from:
Maria Adriana Cataldo and Nicola Petrosillo, National Institute for Infectious Diseases “Lazzaro Spallanzani”, Rome, Italy.