Abstract:
OBJECTIVE:To assess the impact of major interventions targeting infection control and diagnostic stewardship in efforts to decrease Clostridioides difficile hospital onset rates over a 6-year period. DESIGN:Interrupted time series. SETTING:The study was conducted in an 865-bed academic medical center. METHODS:Monthly hospital-onset C. difficile infection (HO-CDI) rates from January 2013 through January 2019 were analyzed around 5 major interventions: (1) a 2-step cleaning process in which an initial quaternary ammonium product was followed with 10% bleach for daily and terminal cleaning of rooms of patients who have tested positive for C. difficile (February 2014), (2) UV-C device for all terminal cleaning of rooms of C. difficile patients (August 2015), (3) "contact plus" isolation precautions (June 2016), (4) sporicidal peroxyacetic acid and hydrogen peroxide cleaning in all patient areas (June 2017), (5) electronic medical record (EMR) decision support tool to facilitate appropriate C. difficile test ordering (March 2018). RESULTS:Environmental cleaning interventions and enhanced "contact plus" isolation did not impact HO-CDI rates. Diagnostic stewardship via EMR decision support decreased the HO-CDI rate by 6.7 per 10,000 patient days (P = .0079). When adjusting rates for test volume, the EMR decision support significance was reduced to a difference of 5.1 case reductions per 10,000 patient days (P = .0470). CONCLUSION:Multiple aggressively implemented infection control interventions targeting CDI demonstrated a disappointing impact on endemic CDI rates over 6 years. This study adds to existing data that outside of an outbreak situation, traditional infection control guidance for CDI prevention has little impact on endemic rates.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Doll ME,Zhao J,Kang L,Rittmann B,Alvarez M,Fleming M,Cooper K,Stevens MP,Bearman Gdoi
10.1017/ice.2020.247subject
Has Abstractpub_date
2020-10-01 00:00:00pages
1142-1147issue
10eissn
0899-823Xissn
1559-6834pii
S0899823X20002470journal_volume
41pub_type
杂志文章abstract:OBJECTIVE:To evaluate the prevalence, epidemiologic features, and molecular characteristics of colonization with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among hospitalized dialysis patients and their healthcare workers (HCWs). DESIGN:Prospective observational clinical and laboratory ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/592983
更新日期:2009-01-01 00:00:00
abstract::We analyzed antibiotic use data from 29 southeastern US hospitals over a 5-year period to determine changes in antibiotic use after the fluoroquinolone US Food and Drug Administration (FDA) advisory update in 2016. Fluoroquinolone use declined both before and after the FDA announcement, and the use of select, alternat...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.247
更新日期:2019-11-01 00:00:00
abstract::The effectiveness of five 30-second handwashes with a non-antiseptic lotion soap to remove nosocomial pathogens (10(8) CFU) applied to fingertips was studied. CFU for all species dropped rapidly after the first handwash; persistence (10 to 15 CFU) was maintained thereafter. Wiping hands with an antiseptic (70% isoprop...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502388
更新日期:2004-03-01 00:00:00
abstract::Adults more than 40 years old are not necessarily immune to measles. A measles outbreak that involved healthcare workers occurred after contact with a 44-year-old patient. Results of a hospital-wide program of mass screening revealed that 117 (4.5%) of 2,600 individuals tested seronegative for measles; 31 (26.1%) of t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/519928
更新日期:2007-09-01 00:00:00
abstract::Group A streptococci account for less than 1% of all surgical wound infections but are an important cause of nosocomial outbreaks. We report here a cluster of four group A streptococcal infections that occurred within an 11-day period on a single surgical service. The index case presented with toxic shock-like syndrom...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646732
更新日期:1993-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/658943
更新日期:2011-04-01 00:00:00
abstract::Healthcare-associated infection reporting validation is essential because this information is increasingly used in public healthcare quality assurances and care reimbursement. Washington State's validation of central line-associated bloodstream infection reporting applies credible quality sciences methods to ensure th...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.303
更新日期:2017-04-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1086/501872
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:To investigate the possibility that contaminated commercial activated charcoal may serve as a source for fungal colonization or infection of the lower respiratory tract. DESIGN:The clinical course of a patient who aspirated commercial activated charcoal was reviewed. Fungal cultures were performed for 2 samp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646281
更新日期:1991-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647046
更新日期:1995-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:2017-06-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/667375
更新日期:2012-09-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2021.8
更新日期:2021-01-25 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646627
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of central venous catheter (CVC) use among patients both within and outside the ICU setting. DESIGN:A 1-day prevalence survey of CVC use among adult inpatients at six medical centers participating in the Prevention Epicenter Program of the CDC. Using a standardized form, observers...
journal_title:Infection control and hospital epidemiology
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doi:10.1086/502163
更新日期:2003-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:1988-04-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:2016-08-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646161
更新日期:1990-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502178
更新日期:2003-02-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:2020-12-29 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647890
更新日期:1998-09-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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更新日期:2016-04-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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abstract::The outbreak of H5N1 avian influenza in Asia has reignited concerns about an influenza pandemic. It is clear that influenza vaccine will be in short supply (or nonexistent) early in an influenza pandemic. Without vaccine, the role of antiviral agents, especially oseltamivir, in treatment and prophylaxis is of paramoun...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502507
更新日期:2005-11-01 00:00:00
abstract::Due to the rapid transfer of patients from the acute-care setting, the intensity of nursing care among residents in long-term-care facilities (LTCFs) has increased, transforming today's LTCFs into subacute healthcare facilities. Given the increased risk of infection among residents in LTCFs and the associated morbidit...
journal_title:Infection control and hospital epidemiology
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
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更新日期:2008-04-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:2020-05-01 00:00:00