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July 25, 2017

Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates

Author Affiliations
  • 1Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
  • 2VA Maryland Healthcare System, Baltimore
  • 3Department of Internal Medicine, Virginia Commonwealth University, Richmond
JAMA. 2017;318(4):329-330. doi:10.1001/jama.2017.7419

Physical barriers have been used to prevent infectious diseases dating back to leather gloves and coats used during the Black Death in medieval Europe. In the United States, isolation of persons with infections coincided with the development of infectious disease hospitals during the 19th century and introduction of “barrier nursing” in 1910, which included the use of gowns for health care workers. The US Centers for Disease Control and Prevention (CDC) released isolation manuals starting in 1970, promoting the idea of specific precautions within 7 categories (such as strict isolation, respiratory isolation, or wound and skin precautions), easily adopted by any type of hospital. The CDC guidance was based on expert opinion and theoretical modes of transmission.

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