{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T14:00:46Z","timestamp":1784815246112,"version":"3.55.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"VA Salt Lake City Health Care System"},{"name":"Centers for Disease Control and Prevention's Epicenter","award":["5U54CK000602-05"],"award-info":[{"award-number":["5U54CK000602-05"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,23]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The effectiveness of contact precautions (CP) and active surveillance (AS) for preventing methicillin-resistant Staphylococcus aureus (MRSA) in acute care remains uncertain. Some studies suggest CP reduces MRSA spread, while others report limited benefit. The COVID-19 pandemic disrupted MRSA prevention practices in the VA, creating an opportunity to assess their impact on MRSA healthcare-associated infections (HAIs).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We studied 121 VA acute care hospitals from July 2020\u2013June 2022. Facility practices (AS, CP for colonized [CPC], CP for infected [CPI]) were assessed via national surveys. Patient-level data identified MRSA HAIs (incident cultures \u22653 days postadmission). Secondary outcomes included sterile-site infections and 30-day postdischarge cultures. Associations between practices and HAI rates were estimated using Poisson, negative binomial, and mixed-effects Poisson regression, adjusting for baseline MRSA burden, COVID-19 admissions, culturing intensity, and hospital characteristics.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 905 164 admissions, 1708 incident MRSA cultures were identified. Many facilities suspended at least one prevention practice early in the pandemic, though most later reinstated them. In simpler models, discontinuation of AS, CPC, or CPI was associated with higher MRSA rates, but these associations were attenuated after adjustment for baseline burden. Mixed-effects models found no significant associations, and results were consistent across secondary outcomes.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Discontinuation of MRSA prevention practices during the pandemic was not consistently linked to increased HAIs after accounting for baseline burden. Findings emphasize the role of facility-specific factors and modeling assumptions in evaluating infection control. Unmeasured pandemic-related practices (eg, masking, PPE use) likely also influenced transmission, highlighting the need for flexible, context-sensitive, evidence-based infection prevention policies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/cid\/ciag176","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T12:54:01Z","timestamp":1773233641000},"page":"e113-e119","source":"Crossref","is-referenced-by-count":0,"title":["Estimating Changes in Facility Methicillin-Resistant\n Staphylococcus aureus<\/i>\n (MRSA) Infection Rates Due to Changes in MRSA Precaution Policy"],"prefix":"10.1093","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7206-8077","authenticated-orcid":false,"given":"Karim","family":"Khader","sequence":"first","affiliation":[{"name":"Informatics, Decision Enhancement, and Analytical Sciences (IDEAS) Center, VA Salt Lake City Health Care System , Salt Lake City, Utah ,","place":["USA"]},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5217-8257","authenticated-orcid":false,"given":"Candace","family":"Haroldsen","sequence":"additional","affiliation":[{"name":"Informatics, Decision Enhancement, and Analytical Sciences (IDEAS) Center, VA Salt Lake City Health Care System , Salt Lake City, Utah ,","place":["USA"]},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8933-5453","authenticated-orcid":false,"given":"Vanessa","family":"Stevens","sequence":"additional","affiliation":[{"name":"Informatics, Decision Enhancement, and Analytical Sciences (IDEAS) Center, VA Salt Lake City Health Care System , Salt Lake City, Utah ,","place":["USA"]},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6503-328X","authenticated-orcid":false,"given":"Lindsay","family":"Visnovsky","sequence":"additional","affiliation":[{"name":"Informatics, Decision Enhancement, and Analytical Sciences (IDEAS) Center, VA Salt Lake City Health Care System , Salt Lake City, Utah ,","place":["USA"]},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Evans","sequence":"additional","affiliation":[{"name":"National Infectious Diseases Service , Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, District of Columbia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loretta","family":"Simbartl","sequence":"additional","affiliation":[{"name":"National Infectious Diseases Service , Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, District of Columbia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"McCauley","sequence":"additional","affiliation":[{"name":"National Infectious Diseases Service , Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, District of Columbia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Samore","sequence":"additional","affiliation":[{"name":"Informatics, Decision Enhancement, and Analytical Sciences (IDEAS) Center, VA Salt Lake City Health Care System , Salt Lake City, Utah ,","place":["USA"]},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2900-5548","authenticated-orcid":false,"given":"Michael","family":"Rubin","sequence":"additional","affiliation":[{"name":"Informatics, Decision Enhancement, and Analytical Sciences (IDEAS) Center, VA Salt Lake City Health Care System , Salt Lake City, Utah ,","place":["USA"]},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"2026072309030107000_ciag176-B1","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1017\/ice.2021.457","article-title":"Discontinuing MRSA and VRE contact precautions: defining hospital characteristics and infection prevention practices predicting safe de-escalation","volume":"43","author":"Martin","year":"2022","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026072309030107000_ciag176-B2","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.ajic.2021.10.044","article-title":"Long-term impact of contact precautions cessation for Methicillin-Resistant Staphylococcus Aureus (MRSA)","volume":"50","author":"AlMohanna","year":"2022","journal-title":"Am J Infect Control"},{"key":"2026072309030107000_ciag176-B3","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1017\/ice.2018.57","article-title":"Impact of discontinuing contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus: an interrupted time series analysis","volume":"39","author":"Bearman","year":"2018","journal-title":"Infect Control Hosp 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