Background
Clostridium difficile‒associated diarrhea is a leading cause of hospital-acquired diarrhea. We sought to
determine whether the institution of a hospital-wide alcohol-based hand rub (ABHR)
policy was associated with an increase in the incidence and/or severity of health
care facility‒onset, health care facility‒associated C difficile diarrhea (CDAD).
Methods
We used a retrospective chart review analysis to compare incidence rates of CDAD before
and after implementation of the ABHR policy. We also compared rates of sepsis, colectomy,
and death in patients with CDAD before and after implementation of the ABHR policy.
Results
The incidence rate of CDAD was 3.98 per 10,000 patient-days after implementation of
the ABHR policy, compared with 4.96 per 10,000 patient-days before implementation
(P = .0036). The crude mortality rate in patients diagnosed with CDAD was 10.7% after
implementation, compared with 13.3% before implementation (P = .275). The rate of sepsis in patients diagnosed with CDAD was 19.6% after implementation,
compared with 5.2% before implementation (P < .0001).
Conclusion
Our data provide no evidence of an increased CDAD rate after implementation of an
ABHR policy at our institution. The rate of sepsis in patients diagnosed with CDAD
did rise, indicating increased severity of illness in patients with C difficile infection.
Key Words
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Article Info
Publication History
Published online: April 14, 2010
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.