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MRSA & VRE in the ICU: Heightened surveillance and barrier precautions didn't reduce transmission (STAR*ICU trial)
Huskins et al cluster-randomized 18 ICUs to an intervention of surveillance cultures with contact precautions for positive patients, or a control of no cultures and universal precautions (gloves). The intervention ICUs used contact precautions more frequently (51% vs. 38%), but had the same MRSA/VRE colonization/infection rates, the primary endpoint (40 vs 35%, p=0.35). Clinician compliance was higher in the intervention group, but only fair with gloves (72-82%), gowns (77%) and hand hygiene (62-69%). (n=9,100) NEJM 2011;364:1407-1418.