Tag Archives: Clostridium difficile reduction

Xavier University Researchers 2015 Study Demonstrated That By Using Launderable Mattress Barrier Cover Could Decrease the Number Of Patients Who Became Infected With C. difficile by 50%

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In 2010 Xavier University researcher
Dr. Edmond Hooker began research delving into a possible link between hospital beds and healthcare acquired infections (HAIs).

It immediately became apparent that hospital mattresses have been frequently linked to outbreaks of HAI;s. Hospital mattresses are soft porous surfaces.

They are designed to allow moisture to move away from the patient to prevent skin breakdown and bedsores. However, this design makes it impossible for the mattress surface to be thoroughly cleaned and disinfected using currently available cleaning products.

Dr. Hooker’s first line of scientific inquiry was to culture the surfaces of mattresses that had been “terminally” cleaned and were ready for the next patient. In 2011, the Xavier team showed that these mattresses were still contaminated with pathogenic bacteria despite having been cleaned.

Again in 2012, while investigating the use of a launderable mattress barrier cover,

Dr. Hooker showed that mattresses cleaned using traditional hospital methods were still contaminated with pathogenic bacteria.

Prior research demonstrated that patients who are placed in a bed where the previous patient had Clostridium difficile (C. diff) and/or other bacterial infections are at an increased risk of acquiring those infections.

In 2015, researchers from Xavier University published the results of a landmark study. It demonstrated that, by using the launderable mattress barrier cover in two long-term acute care hospitals (treating extremely ill patients), they could decrease the number of patients who became infected with C. diff by 50%, even when the beds of C. diff patients had been cleaned using bleach.

Another recent study, just published in JAMA, demonstrated that hospital beds are the vector for transmission of C. diff even from asymptomatic patients who had occupied the same bed and received antibiotics during their hospital stay.

It is clear that the hospital environment, especially the hospital bed, is a major vector in the transmission of C. diff and many other bacteria that cause HAIs.

Healthcare providers must find ways to ensure that hospital mattresses are cleaned and disinfected properly between patients, and that additional non-chemical measures are taken, if available, to protect patients.

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C. diff. News: A Canadian Acute Care Facility Implemented Intervention To Screen and Isolate Asymptomatic Clostridium difficile Carriers With Noted Decreased Incidence Of Health-Care Associated C. difficile Infection

C. diff. In The News

An intervention at a Canadian acute care facility to screen and isolate asymptomatic Clostridium difficile carriers was associated with decreased incidence of
health-care associated C. difficile infection
, a finding that needs to be confirmed in additional studies, according to a new study published online by JAMA Internal Medicine.

C. difficile infection (CDI) is a major cause of health care-associated infection worldwide.
CDI can cause symptoms from mild diarrhea to life-threatening toxic megacolon. About half a million cases happen each year in the United States, causing 29,000 deaths and creating $4.8 billion in excess medical costs.

Infection control recommendations mainly focus on patients with CDI. But asymptomatic
C. difficile carriers may also play a role in disseminating spores because they can
contaminate the environment and caregivers’ hands, and because they are not detected are not placed under isolation precautions.

Yves Longtin, M.D., of the Jewish General Hospital and McGill University, Montreal, Canada, reports on the effects of the intervention to reduce the incidence of health care-associated CDI (HA-CDI)   at the Quebec Heart and Lung Institute, Quebec City, Canada.

The study, conducted between November 2013 and March 2015, screened patients at admission for the tcdB gene through a rectal swab and those found to be C. difficile carriers were put under contact isolation precautions during their hospitalization.

Among the 7,599 patients who were screened, 368 (4.8 percent) were identified as C. difficile carriers and placed under isolation. During the intervention, the incidence rate of HA-CDI decreased by more than 50 percent to 3.0 per 10,000 patient days compared to 6.9 per 10,000 patient days before the intervention. The authors estimate the intervention prevented approximately 63 cases.

Limitations of the study include the intervention was conducted at a single center and the findings still need to be confirmed in additional studies.

The authors note that the strategy to screen and isolate C. difficile carriers may be cost-effective. The intervention cost $130,000 (U.S.) and prevented 63 cases; the estimated savings from averting CDI cases was greater than the cost of the intervention.

“The intervention is simple and could be easily implemented in other institutions. If confirmed in subsequent studies, isolating asymptomatic carriers could potentially prevent thousands of cases of HA-CDI every year in North America,” the study concludes.

Commentary: Active Surveillance, Isolation of Asymptomatic Carriers of Clostridium difficile at Hospital Admission

“The results of this study are promising for reducing HA-CDI. … Longtin et al have shown the possible benefit of using active surveillance testing and isolation of asymptomatic carriers for preventing HA-CDI. Larger, well-designed studies, such as cluster randomized trials, are ultimately needed to confirm the effectiveness of this strategy,” writes Alice Y. Guh, M.D., M.P.H., and L. Clifford McDonald, M.D., of the Centers for Disease Control and Prevention, Atlanta.

TO ACCESS ARTICLE IN ITS ENTIRETY:

Story Source:

The above post is reprinted from materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Yves Longtin, Bianka Paquet-Bolduc, Rodica Gilca, Christophe Garenc, Elise Fortin, Jean Longtin, Sylvie Trottier, Philippe Gervais, Jean-François Roussy, Simon Lévesque, Debby Ben-David, Isabelle Cloutier, Vivian G. Loo. Effect of Detecting and IsolatingClostridium difficileCarriers at Hospital Admission on the Incidence ofC difficileInfections. JAMA Internal Medicine, 2016; DOI: 10.1001/jamainternmed.2016.0177
  2. Alice Y. Guh, L. Clifford McDonald. Active Surveillance and Isolation of Asymptomatic Carriers ofClostridium difficileat Hospital Admission. JAMA Internal Medicine, 2016; DOI: 10.1001/jamainternmed.2016.1118

Cite This Page:

The JAMA Network Journals. “Effort to detect, isolate asymptomatic C. difficile carriers linked to lower incidence.” ScienceDaily. ScienceDaily, 25 April 2016. <www.sciencedaily.com/releases/2016/04/160425141547.htm