Impact of intensive infection control team activities on the acquisition of methicillin-resistant Staphylococcus aureus, drug-resistant Pseudomonas aeruginosa and the incidence of Clostridium difficile-associated disease

Suzuki, Hiromichi; Senda, Junko; Yamashita, Katsushi; Tokuda, Yasuharu; Kanesaka, Yohko; Kotaki, Noriko; Ishihara, Hiroko; Ishikawa, Hiroichi

doi:10.1007/s10156-013-0621-x

Cited by 12 publications

(30 citation statements)

References 30 publications

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“…Bundled interventions with environmental efforts appeared to be more effective than those without them, except in Suzuki et al 36 study, in which a 77% reduction in CDI was seen with strict contact precautions and cohort procedures.…”

Section: Discussionmentioning

confidence: 92%

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

Louh

Greendyke

Hermann

et al. 2017

Infect. Control Hosp. Epidemiol.

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Objective Prevention of Clostridium difficile infection (CDI) in acute care hospitals is a priority for hospitals and clinicians. We performed a qualitative systematic review to update the evidence on interventions to prevent CDI published since 2009. Design We searched Ovid, MEDLINE, EMBASE, The Cochrane Library, CINAHL, ISI Web of Knowledge, and grey literature databases from January 1, 2009 to August 1, 2015. Setting We included studies performed in acute care hospitals. Patients or participants We included studies conducted on hospitalized patients that investigated the impact of specific interventions on CDI rates. Interventions We used the QI-Minimum Quality Criteria Set (QI-MQCS) to assess the quality of included studies. Interventions were grouped thematically: environmental disinfection, antimicrobial stewardship, hand hygiene, chlorhexidine bathing, probiotics, bundled approaches, and others. A meta-analysis was performed when possible. Results Of 3236 articles screened, 261 met the criteria for full-text review and 46 studies were ultimately included. The average quality rating was 82% on the QI-MQCS. The most effective interventions, resulting in a 45% to 85% reduction in CDI, included daily to twice daily disinfection of high-touch surfaces (including bed rails) and terminal cleaning of patient rooms with chlorine-based products. Bundled interventions and antimicrobial stewardship showed promise for reducing CDI rates. Chlorhexidine bathing and intensified hand hygiene practices were not effective for reducing CDI rates. Conclusions Daily and terminal cleaning of patient rooms using chlorine-based products were most effective in reducing CDI rates in hospitals. Further studies are needed to identify the components of bundled interventions that reduce CDI rates.

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Section: Discussionmentioning

confidence: 92%

“…Suzuki et al 36 implemented more stringent isolation requirements, more frequent clinical review of patients colonized with multidrug-resistant organisms, and more restrictive antimicrobial prescribing guidelines. Rates of CDI fell by > 75% (4.71 of 10,000 to 1.08 of 10,000 patient days).…”

Section: Resultsmentioning

confidence: 99%

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

Louh

Greendyke

Hermann

et al. 2017

Infect. Control Hosp. Epidemiol.

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“…The improvement was significant at the 0.05 level for the 15 studies reporting p-values (60%, 15/25). 25,30,31,35–41,43,45,48–50 The odd ratio for developing CDI under the intervention bundle compared to the control period was reported in three studies and ranged from 0.29 to 0.38. 36,38,39 The relative risk was 0.60 in the single study reporting this measure.…”

Section: Resultsmentioning

confidence: 99%

Reducing Clostridium difficile in the Inpatient Setting: A Systematic Review of the Adherence to and Effectiveness of C. difficile Prevention Bundles

Barker

Ngam

Musuuza

et al. 2017

Infect. Control Hosp. Epidemiol.

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Background Clostridium difficile infection (CDI) is the most common infectious cause of nosocomial diarrhea and its prevention is an urgent public health priority. However, reduction of CDI is challenging, because of its complex pathogenesis, large reservoirs of colonized patients, and persistence of infectious spores. The literature lacks high quality evidence for evaluating interventions, and many hospitals have implemented bundled interventions to reduce CDI with variable results. Thus, we conducted a systematic review to examine the components of CDI bundles, their implementation processes, and their impact on CDI rates. Methods We conducted a comprehensive literature search of multiple computerized databases from their date of inception through April 30, 2016. The protocol was registered in PROSPERO. Bundle effectiveness, adherence, and study quality was assessed for each study meeting criteria for inclusion. Results In the 26 studies that met inclusion criteria for this review, we found that implementation and adherence factors to interventions were variably and incompletely reported, making study reproducibility and replicability challenging. Despite contextual differences and the variety of bundle components utilized, all 26 studies reported an improvement in CDI rates. However, given the lack of randomized controlled trials in the literature, assessing a causal relationship between bundled interventions and CDI rates is currently impossible. Conclusions Cluster randomized trials that include a rigorous assessment of the implementation of bundled interventions are urgently needed to causally test the effect of intervention bundles on CDI rates.

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“…The two-year intervention period was divided into two categories, (i) phase I (July 2011 to June 2012) and (ii) phase II (July 2012 to June 2013), as most of the physicians at TMCH agreed to comply with our carbapenem policy in the phase II intervention period after being informed of the results of the phase I intervention period [11]. This study was approved by the ethics committee of TMCH (approved number: 2014e002).…”

Section: Methodsmentioning

confidence: 99%

“…We therefore implemented new regulations regarding our carbapenem policy [11], and since July 2011, carbapenems have been rarely used for the treatment of CAP or HCAP. In this study, we investigated the need for carbapenems to treat CAP and/or HCAP among newly hospitalized adult patients.…”

Section: Introductionmentioning

confidence: 99%

Clinical evaluation of the need for carbapenems to treat community-acquired and healthcare-associated pneumonia

Kamata

Suzuki

Kanemoto

et al. 2015

Journal of Infection and Chemotherapy

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Carbapenems have an overall broad antibacterial spectrum and should be protected against from the acquisition of drug resistance. The clinical advantages of carbapenem in cases of pneumonia have not been certified and the need for antipseudomonal antimicrobial agents to treat healthcare-associated pneumonia (HCAP) remains controversial. We introduced an antimicrobial stewardship program for carbapenem and tazobactam/piperacillin use and investigated the effects of this program on the clinical outcomes of 591 pneumonia cases that did not require intensive care unit management, mechanical ventilation or treatment with vasopressor agents [221 patients with community-acquired pneumonia (CAP) and 370 patients with HCAP]. Compared with the pre-intervention period, age, comorbidities and the severity and etiology of pneumonia did not differ during the intervention period. Carbapenems were rarely used during the intervention period in cases of pneumonia (CAP: 12% vs. 1%, HCAP: 13% vs. 1%), while antipseudomonal beta-lactam use was reduced from 33% to 8% among cases with HCAP. This reduction in the rate of carbapenem administration did not have an impact on the prognosis in the cases of CAP, and the in-hospital mortality was lower among the patients with HCAP during the intervention period (15% vs. 5%, p = 0.013). The causes of death in the cases of HCAP were not directly related to pneumonia during the intervention period. The current study shows that carbapenem use can be avoided in cases of CAP or HCAP that are not in a critical condition. The frequent use of antipseudomonal beta-lactams does not improve the clinical outcomes of HCAP.

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Impact of intensive infection control team activities on the acquisition of methicillin-resistant Staphylococcus aureus, drug-resistant Pseudomonas aeruginosa and the incidence of Clostridium difficile-associated disease

Cited by 12 publications

References 30 publications

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

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

Reducing Clostridium difficile in the Inpatient Setting: A Systematic Review of the Adherence to and Effectiveness of C. difficile Prevention Bundles

Clinical evaluation of the need for carbapenems to treat community-acquired and healthcare-associated pneumonia

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