Visitor PPE Requirements for MRSA Patients
Visitors do not need to wear masks and gowns when visiting patients with MRSA, as there is no evidence supporting routine contact precautions for visitors in this setting.
Evidence Base for Visitor PPE
The recommendation for healthcare personnel to use gloves and gowns when caring for MRSA patients does not extend to visitors based on current evidence:
No controlled trials support broad use of contact precautions for MRSA prevention, and hospitals that have discontinued contact precautions for MRSA have found no impact on MRSA acquisition or infection 1
MRSA transmission occurs primarily through healthcare worker hands during direct patient care activities, not through casual visitor contact 2
A Cochrane systematic review found no eligible studies assessing the effectiveness of gloves, gowns, or masks for preventing MRSA transmission in hospital settings, meaning the evidence base for these interventions remains unestablished 3
Risk Stratification for Visitors
Visitors represent a fundamentally different risk profile than healthcare personnel:
Healthcare personnel contamination occurs during specific high-risk activities: touching endotracheal tubes, bathing patients, handling bedding, and direct patient contact, with contamination rates of 14.3% for gloves and 5.9% for gowns 4
Visitors typically do not perform these high-risk activities that lead to MRSA transmission 4
The highest contamination risk occurs among occupational/physical therapists and respiratory therapists who have intensive patient contact 4
Practical Approach for Visitors
Hand hygiene is the essential intervention for visitors:
Visitors should perform hand hygiene before entering and after leaving the patient room 2
This approach aligns with the understanding that MRSA is transmitted primarily by direct person-to-person contact, usually on hands 2
Important Caveats
If visitors will be performing direct care activities (such as bathing, wound care, or handling contaminated materials), then gloves and gowns should be used 4
Individual hospital policies may vary, and some institutions may require visitor PPE based on local epidemiology or outbreak situations 1
MRSA colonization should never be a barrier to patient visitation or discharge planning 2