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Comment & Response |

Contact Precautions for Patients With Multidrug-Resistant Pathogens—Reply

Daniel J. Morgan, MD, MS1; Keith S. Kaye, MD, MPH2; Daniel J. Diekema, MD, MS3
[+] Author Affiliations
1VA Maryland Healthcare System, Baltimore
2Wayne State University, Detroit, Michigan
3Division of Infectious Diseases, University of Iowa College of Medicine, Iowa City
JAMA. 2015;313(6):630. doi:10.1001/jama.2014.17448.
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In Reply We are aware of the large MOSAR-ICU quasi-experimental trial but disagree that it evaluated the addition of contact precautions to standard precautions. To our reading, the MOSAR study had 2 main phases: (1) comparing enhanced hand hygiene and chlorhexidine bathing with a baseline period and (2) comparing rapid vs conventional screening and isolation of patients with multidrug-resistant organisms, including MRSA and VRE.1 Dr Derde and colleagues imply that their trial compared standard precautions plus chlorhexidine bathing without contact precautions vs active surveillance for MRSA or VRE with contact precautions for those positive for MRSA or VRE.

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February 10, 2015
Lennie P. G. Derde, MD, PhD; Ben S. Cooper, PhD; Christian Brun-Buisson, MD, PhD
1Department of Intensive Care, University Medical Center Utrecht, Utrecht, the Netherlands
2Nuffield Department of Clinical Medicine, University of Oxford, Oxford, England
3Service de réanimation médicale, APHP GH Henri Mondor/ Université Paris Est-Créteil, Creteil, France
JAMA. 2015;313(6):629-630. doi:10.1001/jama.2014.17439.
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