Current infection control practices for multidrug-resistant organisms (MDRO): a survey of the Society for Healthcare Epidemiology of America (SHEA) research network and affiliated US-based hospitals

Objective: To understand current practices for screening, implementing and clearing contact precautions (CP) for multidrug-resistant organisms (MDRO). Design: A survey of US-based SHEA Research Network (SRN) members and Community Healthcare Epidemiologists and Stewards (CHES). Participants: The SRN is a consortium of healthcare facilities collaborating on multicenter research projects. CHES is an SRN-affiliated group of community hospital epidemiologists. Methods: A Research Electronic Data Capture (REDCap) survey was administered between January 7, 2025 and February 25, 2025. Frequencies and proportions were calculated in REDCap and Microsoft Excel. Fisher’s exact and χ 2 tests were calculated in R . Results: Of 134 facilities, 60 (45%) responded; 4 answered only demographic questions and were excluded from analysis. Most facilities (70%) performed active surveillance for ≥1 MDRO, but only 16% employed preemptive CP. All respondents reported using CP for ≥1 MDRO. CP were employed more often for infection than colonization. Clearance protocols to discontinue CP were common for MRSA (97%), C. difficile (95%), and vancomycin-resistant enterococci (82%), but uncommon for Gram-negatives. Training and adherence of frontline staff (70%), unavailability of private rooms (41%), and lack of evidence-based strategies to eradicate reservoirs (34%) were the top 3 identified barriers to MDRO infection control and prevention. Conclusions: Infection control practices varied by infection, colonization, specific MDRO, and time to clearance. Variation may indicate need for more data on transmission risk by disease state, organism, and time. Evidence-based strategies are needed to guide MDRO prioritization and CP duration and clearance policies. Guidance should acknowledge limitations in adherence, availability of private rooms, and persistent environmental reservoirs as major barriers to MDRO containment identified in this survey.