Control of an outbreak of infection with the hypervirulent clostridium difficile BI strain in a University Hospital using a comprehensive " Bundle" approach
Control of an outbreak of infection with the hypervirulent clostridium difficile BI strain in a University Hospital using a comprehensive " Bundle" approach
复制标题
DOI：
10.1086/522654
复制
发表时间：
2007-11-15
影响因子：
11.8
通讯作者：
Paterson, David L.
中科院分区：
文献类型：
--
作者：
Muto, Carlene A.;Blank, Mary Kathleen;Paterson, David L.
Background. In June 2000, the hospital-acquired Clostridium difficile (CD) infection rate in our hospital (University of Pittsburgh Medical Center-Presbyterian, Pittsburgh, PA) increased to 10.4 infections per 1000 hospital discharges (HDs); the annual rate increased from 2.7 infections per 1000 HDs to 7.2 infections per 1000 HDs and was accompanied by an increase in the frequency of severe outcomes. Forty-seven (51%) of 92 HA CD isolates in 2001 were identified as the "epidemic BI strain." A comprehensive CD infection control "bundle" was implemented to control the outbreak of CD infection.Methods. The CD infection control bundle consisted of education, increased and early case finding, expanded infection-control measures, development of a CD infection management team, and antimicrobial management. Process measures, antimicrobial usage, and hospital-acquired CD infection rates were analyzed, and CD isolates were typed.Results. The rates of compliance with hand hygiene and isolation were 75% and 68%, respectively. The CD management team evaluated a mean of 31 patients per month (11% were evaluated for moderate or severe disease). Use of antimicrobial therapy associated with increased CD infection risk decreased by 41% during the period 2003 2005 (). The aggregate rate of CD infection during the period 2001-2006 decreased to 4.8 infections per 1000 P
