31. The Efficacy and Cost-effectiveness of Hospital Environment Cleaning with Potassium Peroxymonosulfate in the control of Hospital-Onset Clostridium difficile Infections
Session: Posters in the Park: Posters in the Park
Wednesday, October 3, 2018: 5:30 PM
Room: N Hall D Opening Reception and Posters in the Park Area
  • ☆IDWeekPoster2018.pdf (286.4 kB)
  • Background: Environment cleaning with sporicidal disinfectant mainly containing of potassium peroxymonosulfate (PP) is considered to be effective to reduce the burden of hospital onset Clostridium difficile infections (HO-CDI), however; few articles referred to cost effectiveness of PP against HO-CDI. The aim of this study is to evaluate the cost-effectiveness of environmental cleaning with PP and determine the factors to reduce HO-CDI.

    Methods: Between pre- PP promoted period (June 2014 to July 2015) and post- PP promoted period (August 2015 to May 2018), we retrospectively compared the amount of PP cost with the HO-CDI cost in Tosei general hospital with 701 beds, Japan. We collected the data of the cost of PP and the estimated HO-CDI associated cost and plotted the longitudinal changes of the total cost during the study period. The estimated HO-CDI associated cost was defined as the same of those in the past report in Japan. Moreover, we compared the prevalence of HO-CDI per 10,000 patient-days (PD), PP consumption, antimicrobial use density (AUD) and day of therapy (DOT) of broad spectrum antibiotics such as 4th generation cephalosporins, carbapenems, quinolones and tazobactam/piperacillin between pre- and post- PP promoted period, using Mann-Whitney u tests, Student's t tests, and multiple regression analysis as appropriate.

    Results: During pre- and post PP promoted period, the median estimated HO-CDI rate was 13.50 (interquartile range (IQR): 11.25-15.0) per 10,000 PD and 6.94 (IQR: 5.0-9.25) per 10,000 PD (p<0.001). Although the cost of PP usage increased from pre- to post- PP promoted period, the total HO-CDI related cost significantly decreased from $160,843 (IQR: 137,086-170,966) to $87,864 (IQR: 66,768-114,882) per month during the study period (p<0.001). On the multiple regression analysis, PP usage and DOT of carbapenems were significantly associated with reduction of HO-CDI rate (p<0.01).

    Conclusion: Introduce of PP environmental cleaning was highly cost effective method to reduce HO-CDI and also decrease prevalence of HO-CDI.

    Takumi Umemura, PhD1,2,3, Yoshikazu Mutoh, M.D2, Aiko Ohta, MPharm1, Makiko Sukawa, CNS2, Miharu Kaneko, CNS2, Koji Kozaki, MPharm1, Takami Shgehiro, BPharm1, Hiroshige Mikamo, MD, PhD3 and Toshihiko Ichihara, MD2, (1)Pharmacy, Tosei General Hospital, Aichi, Japan, (2)Infectious Disease, Tosei General Hospital, Aichi, Japan, (3)Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan


    T. Umemura, None

    Y. Mutoh, None

    A. Ohta, None

    M. Sukawa, None

    M. Kaneko, None

    K. Kozaki, None

    T. Shgehiro, None

    H. Mikamo, None

    T. Ichihara, None

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