Program Schedule

1649
Acquisition of Clostridium difficile Associated with Potentially Contaminated Inpatient Rooms

Session: Poster Abstract Session: Clostridium difficile Infection: Epidemiology, Presentation, Treatment
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • CatherineClostridumdifficileInpatientRooms IDSAOct2_2014_new.pdf (401.2 kB)
  • Background: Hospital rooms of inpatients with Clostridium difficile infection (CDI) can become contaminated with this major pathogen; unless adequately disinfected, rooms can serve as a reservoir where subsequent patients hospitalized in the same room can also become infected with C. difficile (CD). It was incidentally noted that a patient acquired severe CDI while in a room in our hospital that had recently been occupied by another patient with CDI. As a pilot for a new surveillance measure, we sought to estimate the frequency that patients acquire CDI after exposure to a room recently occupied by a patient with CDI.

    Methods: CD test results and room location data were obtained from our 500-bed tertiary care center’s MedMined database. For the purposes of this surveillance pilot, hospital-acquired CDI was defined as positive CD PCR test ≥3 days after admission. A room was defined as “potentially contaminated” when occupied by a patient who had a positive CD test within the prior 14 days. A patient was defined as exposed if he/she occupied a “potentially contaminated” room within 14 days prior to testing positive for CD. The Emergency Department and operating rooms were excluded from the study.

    Results: During the period July-September 2013, 93 patients had a positive CD PCR. Of the 47 hospital-acquired cases, 5 (11%) had developed CDI after exposure to a “potentially contaminated” room (occupied 0-2 days prior by a person with CDI).

    Geographically associated cases

    Room

    Dates same room was occupied

    Date 1st C. difficile positive

    Index

    A

    Jul 23-28

    Jul 22

        HAI

    A

    Jul 28-Aug 18

    Jul 31

     

     

     

     

    Index

    B

    Aug 1–Aug 7

    Aug 1

        HAI

    B

    Aug 7-Sep 5

    Aug 15

     

     

     

     

    Index

    C

    Aug 3-6

    Aug 4

        HAI

    C

    Aug 6-7

    Aug 15

     

     

     

     

    Index

    D

    Jul 22-Aug 23

    Aug 20

        HAI

    D

    Aug 25-Sep 10

    Sep 8

     

     

     

     

    Index

    E

    Sep 9-12

    Sep 11

        HAI

    E

    Sep 12-17

    Sep 16

    Conclusion: In a 3-month period, this specialized surveillance measure uncovered a small but important percentage of inpatients who had acquired CDI potentially from a contaminated room. Our hospital subsequently instituted sporicidal (bleach-based) disinfectants for terminal cleaning of all inpatient rooms. It is relevant to develop computerized algorithms in surveillance systems that can recognize these geographical associations for hospital-acquired infections; this data can then be used to guide environmental health interventions.

    Catherine Williams, B.S.1, Cynthia Whitener, MD2 and Kathleen G. Julian, MD2, (1)Public Health Sciences, Penn State Hershey, Hershey, PA, (2)Penn State Hershey Medical Center, Hershey, PA

    Disclosures:

    C. Williams, None

    C. Whitener, None

    K. G. Julian, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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