# Targeted Contact Precaution Use to Prevent MRSA Transmission

> **NIH VA I01** · BALTIMORE VA MEDICAL CENTER · 2021 · —

## Abstract

Background: There remains tremendous controversy surrounding the pros and cons of contact precautions
for methicillin-resistant Staphylococcus aureus (MRSA). The rationale for this application is that more
knowledge is needed to identify which patients need to be placed on transmission-based contact precautions
(gloves and gowns used by healthcare workers); and when and which patients may not require contact
precautions to prevent the spread of MRSA.
Significance and Impact: Antibiotic resistance is one of the biggest public health challenges of our time. The
application is significant in that it recognizes and addresses the barrier to institutionalizing contact precautions
for all patients with MRSA when busy healthcare personnel (HCP) feel that they may not have time to
continuously don and doff gowns and gloves as they transition from one room to another. If the study results
provide guidance on when contact precautions are most necessary (and when they are not), it may be safe to
recommend reducing the number of times when gowns and gloves are used unnecessarily, while also
providing new evidence on when contact precautions remain essential.
Innovation: The work is innovative in that we are aiming for precision public health to be brought into the field
of antibiotic resistance and all VA medical centers (VAMCs) in the country: the right type of precautions, for
the right type of encounter at the right time.
Specific Aims: Aim 1: Perform a multi-site, geographically diverse cohort study at VA facilities and enroll
patients with MRSA to determine the rate of MRSA transmission to healthcare personnel gloves and gowns in
the ICU and non-ICU setting. Aim 2: Determine which patient risk factors, including comorbid conditions and
severity of illness markers, which patient care interactions and which healthcare personnel types are
associated with greater transmission of MRSA. Aim 3: Develop a dynamic transmission model to compare the
cost-effectiveness of different contact precaution strategies.
Methodology: Across six VAMCs, we will enroll 800 patients who have MRSA in the intensive care unit (ICU)
and non-ICU setting. Research coordinators will randomly observe five healthcare personnel-patient
interactions per patient. Research coordinators will gather data on the patient level factors and on healthcare
personnel patient interaction factors. When the healthcare personnel leave the room, research coordinators
will culture the healthcare personnel's gloves and gown upon room exit. Thus, five healthcare personnel glove
and gown cultures per patient will be obtained, leading to 4,000 glove culture outcomes and 4,000 gown
culture outcomes. The cost-effectiveness aim will use the results from aims 1 and 2 to build a dynamic
transmission model to assess the effectiveness of different contact precaution strategies. For each strategy,
costs will include both direct medical and indirect (i.e., productivity losses) costs.
Implementation/next steps: We will ...

## Key facts

- **NIH application ID:** 10178338
- **Project number:** 1I01HX003368-01
- **Recipient organization:** BALTIMORE VA MEDICAL CENTER
- **Principal Investigator:** ANTHONY D HARRIS
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10178338

## Citation

> US National Institutes of Health, RePORTER application 10178338, Targeted Contact Precaution Use to Prevent MRSA Transmission (1I01HX003368-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10178338. Licensed CC0.

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