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:- Reside in an acute or chronic long-term care facility
- Receive hemodialysis
- On antimicrobials active against MRSA
- Admitted for a suspect staphylococcal infection
- Have areas of chronic open wounds or skin breakdown (e.g. decubitus ulcers)
- Have long-term invasive devices (e.g., gastrostomy tube, endotrachial tube)
- Recurrent infection or colonization with MRSA (patients previously cleared and presenting with new infection or colonization)
- Have other MRSA risk factors as identified by the admitting facility
- 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).
- Consecutive cultures should be at least seven days apart.
- Cultures should be obtained no sooner than one week after completion of decolonization and/or clinical treatment.
- 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
- 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.
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