Clostridium difficile colitis: A retrospective study of incidence and severity before and after institution of an alcohol-based hand rub policy - 11/08/11
, Taylor Strait, MD a, Nicholas Anthony, MD a, Roger Lovell, MD a, H. James Norton, PhD b, Robert Sautter, PhD c, Martin Scobey, MD a
Address correspondence to Nicole Knight, Carolinas Medical Center, Department of Internal Medicine, 1000 Blythe Blvd, Medical Education Building, 5th floor, Charlotte, NC 28203.Abstract |
Background |
Clostridium difficile‒associated diarrhea is a leading cause of hospital-acquired diarrhea. We sought to determine whether the institution of a hospital-wide alcohol-based hand rub (ABHR) policy was associated with an increase in the incidence and/or severity of health care facility‒onset, health care facility‒associated C difficile diarrhea (CDAD).
Methods |
We used a retrospective chart review analysis to compare incidence rates of CDAD before and after implementation of the ABHR policy. We also compared rates of sepsis, colectomy, and death in patients with CDAD before and after implementation of the ABHR policy.
Results |
The incidence rate of CDAD was 3.98 per 10,000 patient-days after implementation of the ABHR policy, compared with 4.96 per 10,000 patient-days before implementation (P = .0036). The crude mortality rate in patients diagnosed with CDAD was 10.7% after implementation, compared with 13.3% before implementation (P = .275). The rate of sepsis in patients diagnosed with CDAD was 19.6% after implementation, compared with 5.2% before implementation (P < .0001).
Conclusion |
Our data provide no evidence of an increased CDAD rate after implementation of an ABHR policy at our institution. The rate of sepsis in patients diagnosed with CDAD did rise, indicating increased severity of illness in patients with C difficile infection.
Le texte complet de cet article est disponible en PDF.Key Words : Clostridium difficile, alcohol-based hand hygiene, Clostridium difficile-associated diarrhea
Plan
| Conflicts of interest: None to report. |
Vol 38 - N° 7
P. 523-528 - septembre 2010 Retour au numéro
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