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A Helpful Guide for CDI Prevention

A Helpful Guide for CDI Prevention

According to the CDC, the mortality rate associated with Clostridium difficile infection (CDI) increased by 400% between 2000 and 2007, due in part to a stronger germ strain. CDI accounts for approximately 14,000 deaths each year in the United States. Current estimates show that the average total cost for a single inpatient CDI is more than $35,000, and the estimated annual cost burden for the healthcare system exceeds $3 billion. “Preventing the transmission of CDI continues to be a serious and difficult challenge in hospitals throughout the U.S.,” says Ruth M. Carrico, PhD, RN, FSHEA, CIC. “The epidemiology of CDI is changing [Figure]. Its presence in hospitals and other health-care settings has caused medical personnel across the entire continuum of care to reevaluate approaches and perspectives to preventing and managing this potentially lethal infection.” A National Action Plan on CDI Prevention The U.S. Department of Health and Human Services released the National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination in 2009. The document, available at www.hhs.gov, provides a roadmap for preventing healthcare-associated infections (HAIs) in acute care hospitals, ambulatory surgical centers, long-term care facilities, and other healthcare settings. CDIs were among the first HAIs specifically targeted in the action plan because rates have been increasing in recent years. The Association for Professionals in Infection Control and Epidemiology (APIC) has been involved in promoting and supporting the elements included in this national plan through development of specific guidance aimed at the healthcare practice level. In 2013, APIC issued an updated implementation guide to help clinicians further protect patients from CDI. The update contains new material and revised content...

Antimicrobial Stewardship Programs: A Call to Action

Over the past 30 years, many multidrug-resistant organisms have emerged across healthcare settings in the United States. At the same time, there has been a dramatic drop in the development and approval of new antibiotics. “The antimicrobial armamentarium has been depleted,” explains Neil Fishman, MD. “As a result, our ability to treat infectious diseases has been severely compromised. Resistant infections are increasing morbidity and mortality while simultaneously increasing healthcare costs.” Research has shown that a multifaceted approach is required to prevent, detect, and control the emergence of antimicrobial-resistant organisms. This includes ensuring that effective and appropriate therapeutic agents are available and that healthcare settings have the diagnostic capacity to rapidly and reliably detect specific pathogens and their antimicrobial susceptibilities. Promoting better infection prevention and control practices and antimicrobial stewardship programs is important in reducing the burden of infectious diseases, Dr. Fishman says. More healthcare facilities nationwide are launching antimicrobial stewardships because they have the potential to reduce the emergence and transmission of resistant pathogens and decrease antimicrobial resistance. A Joint Position Statement on Antimicrobial Stewardship In the April 2012 issue of Infection Control and Hospital Epidemiology, the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS) published a joint position paper focusing on the need for public policy around the issue of antimicrobial stewardship. SHEA, IDSA, and PIDS have been at the forefront of addressing the need for antimicrobial resistance programs for many years, says Dr. Fishman, co-author of the position paper. “Great efforts are needed to improve prevention and control practices throughout the country.” Key Recommendations...

ICAAC 2012: Comparing Approaches to Hand Hygiene Compliance

The Particulars: The standard method for monitoring hand hygiene compliance before and after patient contact does not assess the appropriateness or risk stratification of compliance as described in the World Health Organization’s 5 Moments (5M) hand hygiene audit tool. The accuracy of monitoring compliance in prolonged episodes of patient care that involves long “strings” of hand hygiene activity is uncertain. Data Breakdown: A study compared use of the before-and-after contact method with 5M tools during prospective audits of hand hygiene compliance in two ICUs. The research team assessed overall and per-moment rates of compliance. Overall compliance was significantly over-reported with before-and-after contact method (~9%), when compared with 5M, particularly when episodes included more than three moments. When comparing individual moments, the before-and-after contact method overestimated compliance by 4% (1 moment) to 18% (4 moments). Take Home Pearl: When compared with 5M tools, before-and-after contact method auditing for hand hygiene compliance appears to significantly overestimate...

ICAAC 2012

New research was presented at ICAAC 2012, the 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy, from September 9 to 12 in San Francisco. The features below highlight just some of the studies that emerged from the conference. News Releases iPosters, Videos, Hot Topics, & More!   Featured Highlights Evaluating a Point-of-Care HIV Test In some settings, access to CD4 testing for determining the eligibility for antiretroviral therapy in patients with HIV is constrained. A simple, instrument-free test provided at the point of care may improve access to CD4 testing for patients with HIV in rural areas. Read more. Comparing Approaches to Hand Hygiene Compliance The standard method for monitoring hand hygiene compliance before and after patient contact does not assess the appropriateness or risk stratification of compliance as described in the World Health Organization’s 5 Moments (5M) hand hygiene audit tool. The accuracy of monitoring compliance in prolonged episodes of patient care that involves long “strings” of hand hygiene activity is uncertain. Read more. Viral Coinfections in Children With Respiratory Infections Little is known about the impact of viral coinfections and recently discovered viruses on the epidemiology of respiratory infections (RIs) in pediatric patients. Read more. Influenza Treatment in Infants Among children aged 2 and younger, influenza-associated morbidity is high. It is not clear, however, how the clinical complications, anti-viral treatment patterns, and healthcare use of infants aged 1 or younger during the H1N1 2009 pandemic compares with those of previous pre-pandemic seasons. Read more. Reducing CVC-Related Bloodstream Infections Central venous catheters (CVCs) are frequently used throughout hospitals nationwide, and related bloodstream infections are common among recipients of...
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