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The Minnesota Department of Health recommends the following for discontinuing contact isolation and "removing patient flags" for methicillin-resistant Staphylococcus aureus:

Minnesota guidance for dropping MRSA isolation

September 1, 2008

Minnesota guidance for dropping MRSA isolation

High-risk groups should remain isolated

The Minnesota Department of Health recommends the following for discontinuing contact isolation and "removing patient flags" for methicillin-resistant Staphylococcus aureus1:

Patients with the following risk factors are not eligible for discontinuing contact precautions during their hospital stay:
  1. Reside in an acute or chronic long-term care facility
  2. Receive hemodialysis
  3. On antimicrobials active against MRSA
  4. Admitted for a suspect staphylococcal infection
  5. Have areas of chronic open wounds or skin breakdown (e.g. decubitus ulcers)
  6. Have long-term invasive devices (e.g., gastrostomy tube, endotrachial tube)
  7. Recurrent infection or colonization with MRSA (patients previously cleared and presenting with new infection or colonization)
  8. Have other MRSA risk factors as identified by the admitting facility
Patients may come off contact precautions when the following criteria have been met:
  1. There is documentation of a minimum of three consecutive negative nares cultures and a minimum of three consecutive negative cultures from previously positive sites(s) (where applicable, note B8a).
  2. Consecutive cultures should be at least seven days apart.
  3. Cultures should be obtained no sooner than one week after completion of decolonization and/or clinical treatment.
  4. Cultures do not need to be obtained during one hospitalization; cultures obtained during multiple hospitalizations or from outpatient visits may count toward the three negative cultures needed provided the patient does not fall into the categories outlined [above] at time of culture collection.

Reference

  1. Minnesota Department of Health. Recommendations for Prevention and Control of Methicillin-Resistant Staphylococcus aureus (MRSA) in Acute Care Facilities. 2008. Available on the web at: www.health.state.mn.us.