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Special Organism Isolation: Attempting to Bridge the Gap

  • Jan Evans Patterson (a1) (a2), Rebecca O. Sanchez (a3), Jose Hernandez (a2), Patti Grota (a2) and Kathryn A. Ross (a4)...


There have been many changes in infection control in the 10 years since the last publication of isolation guidelines for hospitals by the Centers for Disease Control and Prevention (CDC). Hospitals since have used the 1988 CDC Update on Universal Precautions as a minimum because it is required by the Occupational Safety and Health Administration. Even before these changes, Lynch and Jackson described the concept of body substance isolation, which is intended primarily to decrease cross-transmission between patients. Many hospitals' universal precautions policies also incorporate the concept of body substance isolation to prevent the transmission of non-bloodborne as well as bloodborne pathogens. The 1988 CDC update states that the use of universal precautions does not eliminate the need for other category- or disease-specific isolation, or an institution's own system of isolation precautions.

West Haven Veterans Affairs Medical Center in Connecticut and the University Health System and Audie L. Murphy Memorial Veterans Hospital in San Antonio, Texas, have adopted a universal precautions/body substance isolation (UP/BSI) policy as a standard for all patients in an attempt to lessen the confusion. All three hospitals are large, university-affiliated, tertiary care teaching institutions. Blood and all body fluids or tissue from all patients are considered potentially infectious and barrier precautions are used accordingly. Body substance isolation has been shown to decrease the transmission of some non-blood-borne pathogens.


Corresponding author

Department of Medicine (Infectious Diseases), The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr. San Antonio, TX 78284-7881


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1.Garner, JS, Simmons, BPGuideline for isolation precautions in hospitals. Infect Control 1983;4:245325.
2.Centers for Diseases Control. Update: universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other bloodborne pathogens in health-care settings. MMWR 1988;37:377388.
3.Jackson, MM, Lynch, P. Infection control: too much or too little?Am J Nurs 1984;208210.
4.Lynch, P, Cummings, MJ, Roberts, PL, Herriott, MJ, Yates, B, Stamm, WE. Implementing and evaluating a system of generic infection precautions: body substance isolation. Am J Infect Control 1990;18:1:112.
5.Lynch, P, Jackson, MM, Cummings, MJ, Stamm, WE. Rethinking the role of isolation practices in the prevention of nosocomial infections. Ann Intern Med 1987;107:243246.
6.Pugliese, G, Lynch, P, Jackson, MM, eds. Universal Precautions. Chicago, IL: American Hospital Publishing, Inc, 1991.
7.Livomese, LL, Dias, S, Samuel, C, et al.Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med 1992;117:112116.
8.Zervos, MJ, Kauffman, CA, Therasse, PM, Bergman, AG, Mikesell, TS, Schaberg, DR. Epidemiology of nosocomial infection caused by gentamicin-resistant Streptococcus faecalis. Ann Intern Med 1987;106:687691.
9.Handwerger, S, Raucher, B, Altarac, D, et al.Nosocomial outbreak due to Enterococcus faecium highly resistant to vancomycin, penicillin, and gentamicin. Clin Infect Dis 1993;16:750755.
10.Karenfil, LV, Murphy, M, Josephson, A, et al.A cluster of vancomycin-resistant Enterococcus fuecium in an intensive care unit. Infect Control Hosp Epidemiol 1992;13:195200.
11.Patterson, JE, Vecchio, J, Pantelick, EL, et al.Association of contaminated gloves with transmission of Acinetobacter calcoaceticus var. anitratus in an intensive care unit. Am J Med 1991;91:479483.
12.Hartstein, AI, Rashad, AL, Liebler, JM, et al.Multiple intensive care unit outbreak of Acinetobacter calcoaceticus subspecies anitrutus respiratory infection and colonization associated with contaminated, reusable ventilator circuits and resuscitation bags. Am I Med 1988;85:624631.
13.McFarland, LV, Mulligan, ME, Kowk, YY, Stamm, WE. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med 1989;320:204210.

Special Organism Isolation: Attempting to Bridge the Gap

  • Jan Evans Patterson (a1) (a2), Rebecca O. Sanchez (a3), Jose Hernandez (a2), Patti Grota (a2) and Kathryn A. Ross (a4)...


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