Decreasing Clostridium difficile health care-associated infections through use of a launderable mattress cover.
BACKGROUND
The annual incidence of Clostridium difficile infection (CDI) in the United States is estimated to be 330,000 cases. We evaluated the impact of using a launderable mattress and bed deck cover on the incidence of hospital-onset CDI in 2 long-term acute care hospitals (LTACHs).


METHODS
Two LTACHs began using a launderable mattress and bed deck cover on beds starting in May 2013. One facility had 74 beds, and the other had 30 beds. Covers were changed after every patient. The covers were laundered using hot water, detergent, and chlorine. Rates for CDIs were compared using Poisson regression between the 16 months before use of the launderable cover and the 14 months after the cover started being used.


RESULTS
At hospital A, the use of bedcovers reduced the rate of infection by 47.8% (95% confidence interval [CI], 47.1-48.6), controlling for the rate of handwashing compliance and length of stay in days. At hospital B, the use of bedcovers reduced the rate of infection by 50% (95% CI, 47.5-52.7), controlling for the rate of handwashing compliance and length of stay in days.


CONCLUSIONS
The use of a launderable cover for mattresses and bed decks of hospital beds was associated with a decreased rate of health care-associated CDI in 2 LTACHs.
Department of Health Services Administration, Xavier University, Cincinnati, OH; Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH. Electronic address: ehooker@mac.com.
Edmond A
EA
Hooker
Infectious Disease of Indiana, Carmel, IN.
Mark
M
Bochan
Saint Vincent Health, Indianapolis, IN.
Troy T
TT
Reiff
Saint Vincent Health, Pendleton, IN.
Catherine
C
Blackwell
Medxcel Facilities Management, Indianapolis, IN.
Kevin W
KW
Webb
Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH.
Kimberly W
KW
Hart
D000368:Aged; D001512:Bedding and Linens; D001513:Beds; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D004203:Disinfection / Q000379:methods*; D006797:Housekeeping, Hospital / Q000379:methods*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D014481:United States / Q000453:epidemiology
Clostridium difficile; Hospital-acquired infections; Launderable cover; Long-term acute care hospitals; Mattress