Yale
New Haven Hospital
QISS
GB 325
New Haven, CT
06504 USA
Dr. Jeff Topal
688-4634
Discontinuation of Contact Precautions
Contact Precautions can be discontinued if:
1)
Two sequential perirectal swabs obtained a minimum of 24 hours apart are negative. The specimen should be sent to the Epidemiology Laboratory. Use a pink manual microbiology slip for the specimen. Indicate the date, specimen type and "R/O VRE" on the slip.
2)
Two sequential cultures from the site of infection/colonization (if applicable) obtained 24 hours apart are negative. The cultures must be labelled "R/O VRE" if obtained from a body site that is usually not sterile (e.g. wound, decubitius, etc.).
3)
Preferably, the patient should be off all antibiotics for a minimum of 48 hours assuming normal renal function (If the patient has impaired renal function or is on dialysis, then the appropriate interval of time for clearance of all antibiotics should have elapsed before culturing the patient).
Note: VRE colonization is usually prolonged (weeks to years), especially in EDRD, HIV, transplant, and oncology patients. Additionally, patients can flip/flop during an inpatient admission; therefore, attempting to remove a patient from Contact Precautions for VRE is usually not a successful endeavor.
