Contact Isolation for Infectious Diarrhea: Protocol, PPE, and Duration
Contact isolation is the standard precaution for infectious diarrhea caused by C. difficile, norovirus, rotavirus, EHEC, Shigella, Salmonella, and parasites.
Key Elements of Contact Isolation
- Private room preferred; cohort patients with the same pathogen if single rooms are unavailable.
- PPE: Gown and gloves on entry; remove before exit. Hand hygiene with soap and water — alcohol-based sanitizers are ineffective against C. difficile spores and norovirus.
- Dedicated equipment: Stethoscope, BP cuff, and thermometer remain in the room.
- Environmental cleaning: Daily and terminal cleaning with sporicidal agent (bleach 1:10 or EPA List K) for C. difficile; standard disinfectant for other pathogens. Focus on high-touch surfaces.
- Visitor restrictions: PPE required; limit numbers; educate on hand hygiene.
- Transport: Patient wears gown/gloves if leaving room; clean receiving area afterward.
Duration of Isolation
- C. difficile: Until diarrhea resolves + 48 hours after formed stool
- Norovirus: 48–72 hours after symptom resolution
Antimicrobial stewardship reduces C. difficile incidence.
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