Clinical use of bioclean rooms in Japan with special reference to medical isolators

A survey on the clinical use of medical isolators was undertaken by sending out a questionnaire to the major medical and pediatric oncology services in Japan. As of December, 1981, laminar-air-flow rooms (LAFR) were installed in hospital rooms of 79 institutions. To date, 68 patients with leukemia, 12 with malignant lymphoma and 10 with aplastic anemia have been treated in LAFR for the purpose of bone marrow transplantation. So far, 501 patients with leukemia, 24 with malignant lymphoma and 14 with solid tumor have been treated in LAFR for the purpose of intensive chemotherapy. A variety of items as to the clinical use of medical isolators, such as type of LAFR, decontamination of isolators, protective clothing, food and gut sterilization and attending staff were surveyed. There remain many problems in the use of medical isolators, such as the high cost of establishing and maintaining a bioclean system, the shortage of nursing staff, the lack of space and accessory equipment and so on. Nevertheless, the author will continue to recommend isolation with a physical barrier, protective clothing for attending staff, pathogen-free food and oral prophylactic anti-microbial agents.