Quick Reference: Isolation Precautions for Commonly Identified Organisms and Infections

Ext. 5-0284 or 50-BUG

Private
Organisms/Infections Precautions Cohort? Duration/Comments
Room?
Multi-Drug Resistant Organisms
MRSA Yes, regardless of Until sputum is negative & two nares screens collected on separate days are
Contact & Droplet Yes
pneumonia site negative.
MRSA Yes, regardless of Until site is negative & two nares screens collected on separate days are
Contact Yes
colonization or all other sites site negative.
VRE Contact (add Droplet if Yes, regardless of
Yes Duration of stay & subsequent admissions.
vancomycin resistant Enterococcus in sputum) site
ESBL Contact (add Droplet if
Yes No Duration of stay & subsequent admissions.
Extended spectrum beta-lactamase in sputum)
CRE Contact (add Droplet if
Yes No Duration of stay & subsequent admissions.
carbapenem-resistant in sputum)
Resistant GNR (gram-negative rods)
Contact (add Droplet if
(including MDR Pseudomonas & MDR Yes No Duration of stay & subsequent admissions.
in sputum)
Acinetobacter )
Influenza, seasonal and influenza like illness
Yes, if same type
PCR positive Droplet Yes 7 days after onset, if symptoms have resolved
only
suspected Until viral respiratory screen & influenza PCR are negative, or duration of
Droplet Yes No
(regardless of rapid test results) symptoms.
Clostridium difficile
Until diarrhea resolves. Room must then be terminally cleaned with a bleach
Clostridium difficile (C. diff) Enhanced Contact Yes No
solution. Follow-up testing is NOT needed to d/c precautions.
Meningitis
Standard - Adults
Aseptic (viral) Contact - Infants & No Duration of hospitalization
young children
Bacterial, gram-negative enteric in
Standard No
neonates
Fungal Standard No
Haemophilus influenzae type B
Droplet Yes Until 24 hours after antibiotics are started
known or suspected
Listeria monocytogenes Standard No
Neisseria meningitidis (meningococcal)
Droplet Yes Until 24 hours after antibiotics are started
known or suspected
Streptococcus pneumoniae Standard No
Concurrent, active pulmonary disease or draining cutaneous lesions may
M. tuberculosis meningitis Standard No necessitate addition of Contact or Airborne Precautions. For children, Airborne
Precautions until active pulmonary TB is ruled out in active family members.
Other diagnosed bacterial Standard No
Varicella
Until lesions are dry and crusted. Negative pressure room. Staff who are
Chickenpox Airborne & Contact Yes No
susceptible to varicella should not enter.
Shingles/zoster, Until lesions are dry and crusted. Negative pressure room. Staff who are
Airborne & Contact Yes No
disseminated susceptible to varicella should not enter.
Shingles/zoster, localized
Standard Preferred Yes
can be covered
Shingles/zoster, localized
Contact Yes Yes Until lesions are dry and crusted.
can NOT be covered
Tuberculosis
Until patient is improving clinically, & drainage has ceased or there are three
Extrapulmonary,
Airborne & Contact Yes No consecutive negative cultures of drainage. Examine for evidence of active
draining lesion
pulmonary tuberculosis.
Extrapulmonary, Examine for evidence of pulmonary TB. For infants & children, use Airborne
no draining lesion, Standard No precautions until active pulmonary TB in visiting family members has been ruled
meningitis or blood out.
Discontinue precautions only when patient on effective therapy is improving
Pulmonary or laryngeal disease,
Airborne Yes No clinically & has three consecutive sputum smears negative for acid-fast bacilli
confirmed
collected on separate days.
Discontinue precautions only when the likelihood infectious TB is deemed
negligible, & either 1) there is another diagnosis that explains the clinical
Pulmonary or laryngeal disease,
Airborne Yes No syndrome, or 2) the results of three sputum smears for AFB are negative. Each
suspected
of the three specimens should be collected 8-24 apart, and at least one should
be an early morning specimen.
Skin test or T-spot positive,
Standard No
no evidence active disease
Viral respiratory diseases (other than influenza)
Human metapneumovirus Contact Yes Yes, w/ same virus Duration of illness
Parainfluenza virus,
Contact Yes Yes, w/ same virus Duration of illness
infants and young children
Rhinovirus Droplet Yes Yes, w/ same virus Duration of illness
Coronavirus
Droplet Yes Yes, w/ same virus Duration of illness
(not associated with SARS or MERS)
RSV, infants and young children Contact Yes Yes, w/ same virus Duration of illness