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Basic measures curb C. difficile in hospitals

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Disinfectant use and other simple interventions are helpful in combating Clostridium difficile, a major infectious cause of healthcare-associated diarrhea, researchers report in a July 6th on-line paper in Gastroenterology.

As Dr. Nasia Safdar told Reuters Health by email, “Institutions should take steps to ensure that they have a robust program for promoting antimicrobial stewardship, environmental cleaning and compliance with hand hygiene and contact precautions as these are major measures for prevention of C. Difficile infection in healthcare institutions.”

She and her colleagues at the University of Wisconsin-Madison School of Medicine and Public Health, who note that as many as 25% of such cases may be caused by the pathogen, reviewed data from 38 studies examining preventative measures.

Approaches included use of disposable thermometers, use of gloves, hand hygiene, surveillance and employment of probiotics. The study periods ranged from as little as days to as long as 10 years.

Results were not uniformly consistent. For example, one study found waterless alcohol hand rub to be helpful, another did not. However, overall, the researchers recommend hand hygiene with soap and water.

Because many studies employed multiple concurrent interventions, the contribution of each was difficult to evaluate. Those apparently beneficial include use of disposable thermometers, wearing of gloves, environmental disinfection and antimicrobial usage monitoring.

A number of trials examined the use of probiotics but lacked adequate statistical power to determine their efficacy. “The role of probiotics,” Dr. Safdar concluded, “needs addressing in research studies.”

Prevention of Endemic Healthcare-Associated Clostridium difficile Infection: Reviewing the Evidence
Am J Gastroenterol 2010.