Protecting Our Patients From C Diff

Posted on Aug 1, 2012 in Infection Prevention | Comments Off on Protecting Our Patients From C Diff

Clostridium difficile has hit some areas of the nation in epidemic proportions. ABSMC continues to identify patients with community and hospital-acquired disease. The new Contact Precautions for C. diff must be instituted at first suspicion. This means gowns and gloves must be worn by all entering the room. The patient’s environment is likely contaminated as well.  Hands must be washed with soap and water when leaving the room. All surfaces in the patient room are cleaned daily with bleach wipes. Compliance with Precautions by health care personnel is vital in preventing the spread of C. diff.

Although rarely seen at ABSMC, health care facilities are also dealing with carbapenem-resistant Enterobacteriaceae (CRE), deadly pathogens that cause heath care-associated infections.  CRE are resistant to almost all drugs and can contribute to death in 40 percent of patients who become infected. CRE were first reported in the U.S. in 2001 and seem to be regional, although there is the definite potential for spread. In our area, CRE is mostly seen as Klebsiella pneumoniae carbapenemase (KPC). CRE often carry genes that confer high levels of resistance to many other antimicrobials.

CDC Recommendations:

  • Identify colonized and infected patients when present in the facility
  • Hand hygiene is a primary part of preventing multidrug-resistant organism (MDRO) transmission.
  • Place colonized and infected patients in Contact Precautions (gowns, gloves, hand hygiene)
  • Educate MD and staff regarding proper use of Contact Precautions (presently at ABSMC, Contact Precautions are used for all MDROs)
  • Minimizing device use (central line, urinary catheters, ET tubes) is an important part to decrease the incidence of CRE and other MDROs.
  • Antibiotic stewardship is another key element in CRE and MDRO control, especially in critical care and long-term care.
  • Chlorhexidine bathing has been successful in preventing HAIs and decreasing the colonization of certain MDROs.

The medical center and physicians will need to be prepared for this next challenge to protect our hospitalized patients from antimicrobial resistant organisms.