Document Detail

Nosocomial pneumonia is not prevented by protective contact isolation in the surgical intensive care unit.
MedLine Citation:
PMID:  11768817     Owner:  NLM     Status:  MEDLINE    
Nosocomial pneumonia (NP) is the leading cause of death from hospital-acquired infection in intubated surgical intensive care unit (SICU) patients. To determine whether protective contact isolation would lower the incidence of NP in intubated patients we performed a prospective, randomized, and controlled study in two SICUs in a tertiary medical center. Over a period of 15 months two identical ten-bed SICUs alternated for 3-month periods between protective contact isolation (isolation group) and standard "universal precautions" (control group). In the isolation group all personnel and visitors donned disposable gowns and nonsterile gloves before entering an intubated patient's room; handwashing was required before entry and on leaving the room. In the control group caregivers utilized only "standard precautions" including handwashing and nonsterile gloves for intubated patients. Respiratory cultures were obtained 48 hours after SICU admission and every 48 hours thereafter until extubation, transfer to floor care, or death. Airway colonization (AC) occurred in 72.7 per cent of isolated patients and 69.0 per cent of control patients (P = 0.61). The incidence of NP was significantly higher in the isolation group (36.4%) compared with the control group (19.5%) (P = 0.02). There was no statistically significant difference between groups in days from SICU admission to AC, days to NP, and mortality. We conclude that protective contact isolation with gowns, gloves, and handwashing is not superior to gloves and handwashing alone in the prevention of AC and NP in SICU patients and may in fact be detrimental.
W G Koss; T M Khalili; J F Lemus; M M Chelly; D R Margulies; M M Shabot
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American surgeon     Volume:  67     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-12-21     Completed Date:  2002-01-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1140-4     Citation Subset:  IM    
Burns and Allen Research Institute, Department of Surgery, Cedars-Sinai Medical Center and the UCLA School of Medicine, Los Angeles, California 90048, USA.
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MeSH Terms
Aged, 80 and over
Cross Infection / epidemiology,  prevention & control*
Gloves, Protective
Intensive Care Units*
Length of Stay
Middle Aged
Patient Isolation*
Pneumonia / epidemiology,  prevention & control*
Prospective Studies

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