Clostridium difficile colitis: A retrospective study of incidence and severity before and after institution of an alcohol-based hand rub policy

Clostridium DifficileInfection in Acute Care Hospitals: Systematic Review and Best Practices for Prevention

“…Knight et al 19 found that a hospitalwide policy advocating alcohol-based hand rub instead of soap and water significantly reduced CDI in acute-care hospitals, even though alcohol-based hand rub does not eradicate spores of C. difficile . The researchers hypothesized that improved hand hygiene compliance may have played a role in CDI reduction.…”

Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals: 2014 Update

“…Although alcohol-based hand hygiene products are ineffective at removing or disinfecting C. difficile spores in controlled laboratory experiments, no clinical study has demonstrated an increase in CDI with the use of these products or a decrease in CDI with soap and water. [62][63][64][65][66][67][68] Conversely, several of the studies did identify decreases in MRSA [63][64][65]68 or VRE 64 associated with the use of alcohol-based hand hygiene products. A recent intensive care unit-based study found admission to a room of a patient with CDI to be a risk factor for CDI, but 90% of patients who developed CDI did not have this risk factor.…”

“…89 When considering whether to promote hand washing over alcoholbased hand hygiene products after caring for a patient with CDI, one should also consider that contamination of hands is less common when gloves are worn for the patient encounter; 59 in addition, as previously stated several clinical studies have not found an increase in CDI with alcohol-based hand hygiene products, but several did find reductions in MRSA or VRE. [62][63][64][65][66][67][68] II. Special approaches for preventing CDI When CDI incidence remains higher than the institution's goal, a CDI risk assessment should be performed.…”

Role of the hospital environment in disease transmission, with a focus on Clostridium difficile

“…75 Multiple studies have reported that increased use of alcohol-based hand rubs was not associated with an increase in CDI and was often associated with a reduction of healthcare-associated infections. [76][77][78][79][80][81] Hospitalised patients with CDI should be placed on Contact Precautions: private room, use of gloves and gowns by both healthcare providers and visitors when entering the room, limiting patient movement throughout the hospital, preferential use of dedicated patient care equipment, and disinfection of all shared patient care equipment between patients. The current Centers for Disease Control and Healthcare Infection Control Practices Advisory Committee (CDC/HICPAC) Guideline on Isolation Precautions recommends that healthcare providers caring for patients with CDI use soap and water for hand hygiene rather than waterless antiseptic handrubs.…”