1381. Cleanliness in Long Term Care Facilities and Clostridium difficile Infection (CDI)
Session: Poster Abstract Session: HAI: Long Term Care
Friday, October 28, 2016
Room: Poster Hall

C. difficile transmission is thought to occur in part via the contaminated environment. In this study, VA Community Living Center (CLC) - onset CDI rates and environmental C. difficilecontamination were measured.


6 VA CLCs participated in a CDC-sponsored CDI pilot initiative to reduce C. difficile transmission in long term care from July 2014 - July 2015. One component involved assessment of environmental contamination. Environmental specimens were collected from high touch surfaces using pre-moistened culturette swabs and processed by 2 labs experienced in recovering C. difficile. Surfaces sampled monthly from each CLC included random resident rooms with associated bathrooms; all rooms of residents in CDI isolation, and standardized common area surfaces. CLC-onset CDI rates were determined as per NHSN Lab Identified Event definitions.

Results: C. difficile Rates in 6 VA CLCs


C. difficile contamination was lower than expected in the VA long term care environment.

C. difficile environmental contamination and CLC-onset CDI rates were not correlated.

Environmental cleaning may not be an effective intervention for reducing rates of CDI in long term care.

Additional interventions that may be necessary in long term care include antimicrobial stewardship.

Jeanmarie Mayer, MD, Medicine, VA Salt Lake City Health Care System, Salt Lake City, UT; Medicine, University of Utah School of Medicine, Salt Lake City, UT, Molly Leecaster, PhD, Salt Lake City VA Health Care System, Salt Lake City, UT, Susan M. Pacheco, MD, Infectious Diseases, Northwestern University, Chicago, IL, Curtis J. Donskey, MD, Infectious Diseases, Case Western Reserve University, Cleveland, OH, Judith Strymish, MD, VA Boston HCS, West Roxbury, MA, Kalpana Gupta, MD, MPH, VA Boston Health Care System, Boston, MA, J Bradford Bertumen, MD, Infectious Disease, Duke University Medical Center, Durham, NC, Edward Young, MD, FIDSA, Medicine, Michael E. DeBakey VA Medial Center, Houston, TX, Matthew Samore, MD, FSHEA, University of Utah School of Medicine, Division of Epidemiology, Salt Lake City, UT and Dale Gerding, MD, FIDSA, Loyola University and Hines VA Hospital, Hines, IL


J. Mayer, None

M. Leecaster, None

S. M. Pacheco, None

C. J. Donskey, None

J. Strymish, None

K. Gupta, None

J. B. Bertumen, None

E. Young, None

M. Samore, None

D. Gerding, Merck: Scientific Advisor , Consulting fee
ViroPharma/Shire: Consultant , Consulting fee
Pfizer: Consultant , Consulting fee
Actelion: Scientific Advisor , Consulting fee
Summit: Scientific Advisor , Consulting fee
DaVolterra: Consultant , Consulting fee
Sanofi Pasteur: Consultant , Consulting fee
Rebiotix: Scientific Advisor , Consulting fee
Seres Therapeutics: Grant Investigator , Research grant

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