Effectiveness of infection control program in controlling nosocomial Clostridium difficile.
OBJECTIVE
To report the effectiveness of use of comprehensive infection control measures to reduce the incidence of Clostridium difficile (CD) in an acute-care teaching hospital.


METHODS
All CD infections were reviewed by the infection control coordinator from 1987 to 1996. The Centers for Disease Control and Prevention's nosocomial infection definition was used. CD-inclusion criteria remained unchanged during the study period. Interventions were started in 1990.


METHODS
The interventions used were: (1) Isolation policy-revision and enforcement, which included universal precautions policy, (2) educational program-monthly to all health care workers, (3) phenolic disinfectant for environmental cleaning, (4) triclosan (0.03%) soap for handwashing, (5) centralization of sterilization department, (6) cart-washer installation, and (7) aggressive surveillance activity.


RESULTS
From 1987 to 1989, before the interventions, a total of 466 CD infections (mean 155 per year) occurred. From 1990 to 1996, after the interventions, 475 infections (mean 67 per year) occurred. Incidence of CD decreased by 60% from 1990 to 1996.


CONCLUSIONS
The sustained decrease of nosocomial CD during the 7-year period demonstrated the effectiveness of aggressive infection control measures that involve multiple disciplines.
Zafar
A B
AB
Infection Control, Administration, Infectious Diseases, Pharmacy, Quality Assurance, Columbia Arlington Hospital, VA 22205, USA.
Gaydos
L A
LA
Furlong
W B
WB
Nguyen
M H
MH
Mennonna
P A
PA
D016360:Clostridioides difficile; D003428:Cross Infection / Q000517:prevention & control*; D004761:Enterocolitis, Pseudomembranous / Q000517:prevention & control*; D005260:Female; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D015397:Program Evaluation; D014768:Virginia