Contact isolation in the intensive care unit: why, when and adverse effects

Abstract

Contact isolation of patients carrying or infected with multidrug-resistant bacteria in the intensive care unit is a routine policy, usually promoted by the scientific societies. Its purpose is to limit and control the spread of multidrugresistant bacteria. These measures are expensive and sometimes difficult to apply in the endemic situation of France. They should certainly not be abandoned but considered in regards to the local epidemiology and the level of compliance with standard precautions in each unit. There are numerous ethical problems, other psychological consequences, and adverse effects due to contact isolation and cohorting, which should be known and considered for the balance of collective risk versus individual benefit.