Lower burden in the care of patients with 3GCR-GNB colonization after removing contact precautions: A trend study among HCWs in German ICUs

Am J Infect Control. 2025 Jun;53(6):701-706. doi: 10.1016/j.ajic.2025.02.010. Epub 2025 Feb 20.

Abstract

Background: Multidrug-resistant organisms pose a significant challenge in intensive care units (ICUs). Despite contact precautions (CP) being recommended as an infection prevention measure, little is known about the burden of CP on health care workers (HCWs).

Methods: An online survey was conducted between May 2021 and August 2022 at baseline (BP) and intervention period (IP) of a multicenter trial discontinuing CP for patients colonized with third-generation cephalosporin resistant gram-negative bacteria in which 38 ICUs participated.

Results: 147 HCWs from 33 ICUs (BP), 154 HCWs from 38 ICUs (IP) responded to the survey. At BP, most burdensome were: donning personal protective equipment (PPE) in case of emergency (84.0%), need of additional time (73.5%), elevated time management requirements to complete all daily tasks (68.7%), transport to diagnostic areas (65.2%). A significant reduction during IP was shown for: transport to diagnostic areas (p = .010), elevated time management requirements to complete all daily tasks (p = .004), need of additional time (p = .020), donning and doffing PPE (p = .014), increased hand and surface disinfection (p = .035) and anxiety (p = .031).

Conclusions: Removing CP may be associated with considerable relief in burden for HCWs. However, removing CP must be guided by defined evidence since infection prevention control must be ensured.

Keywords: Health care workers; Infection prevention; Intensive care unit; Nosocomial infections; Occupational burden.

Publication types

  • Multicenter Study

MeSH terms

  • Cross Infection* / microbiology
  • Cross Infection* / prevention & control
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Germany
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacterial Infections* / prevention & control
  • Health Personnel* / statistics & numerical data
  • Humans
  • Infection Control* / methods
  • Intensive Care Units*
  • Male
  • Personal Protective Equipment
  • Surveys and Questionnaires