- Title
- Which trial do we need? Gown and glove use versus standard precautions for patients colonized or infected with methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus
- Creator
- Browning, Sarah; White, Nicole M.; Raby, Edward; Davis, Joshua S.; Mitchell, Brett G.
- Relation
- Clinical Microbiology and Infection Vol. 30, Issue 8, p. 973-976
- Publisher Link
- http://dx.doi.org/10.1016/j.cmi.2024.05.009
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2024
- Description
- Background: Gown and glove use as a component of ‘contact precautions’ was first recommended by the United States Healthcare Infection Control Practices Advisory Committee in 1996 and remains widely adhered to today [1,2]. Despite a lack of randomized trial evidence in support of this practice, donning of gowns and gloves upon entry to the patient area (room or cubicle) continues to be ‘strongly recommended’ when the patient is infected or colonized with pathogens of epidemiological importance and the.. Study design: We propose a large-scale, pragmatic cluster randomized trial using routinely collected microbiological and surveillance data, which encompasses all sterile and non-sterile site VRE and MRSA detections as a primary outcome measure. The question we plan to address is: is the use of contact precautions without gowns and gloves non-inferior to the use of contact precautions including gowns and gloves, in terms of the monthly incidence of MRSA and/or VRE from both clinically collected and routine... Study population, intervention, and control: Participating hospitals will be selected from those with greater than 300 beds and an intensive care unit, where gowns and gloves are routinely used for the care of patients known to be MRSA or VRE colonised. We will aim to include over 50 hospitals across several countries. After a 12-month period of prospective baseline measures, hospitals will be randomized in parallel to the intervention arm (discontinuation of gown and glove use as a part of contact precautions) versus standard of care ... Barriers: Despite a growing body of evidence and expert opinion in support of removing the routine use of gowns and gloves for contact precautions, [15,16] many clinicians maintain a deeply ingrained belief in the necessity of this practice when treating patients with MRO colonization. This means that definitive evidence is needed and that running and RCT will be challenging. Because observational studies are subject to bias and vary substantially in design across regions, we argue that a large,...
- Subject
- contact precautions; MRSA; VRE; healthcare
- Identifier
- http://hdl.handle.net/1959.13/1513291
- Identifier
- uon:56707
- Identifier
- ISSN:1198-743X
- Language
- eng
- Reviewed
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