Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission

Johnson, Stuart; Gerding, Dale N.; Olson, Mary M.; Weiler, Mary; Hughes, Rita; Clabots, Connie; Peterson, Lance R.

doi:10.1016/0002-9343(90)90462-m

Cited by 300 publications

(143 citation statements)

References 24 publications

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“…In one report, the use of disposable vinyl gloves was observed to reduce the incidence of CDAD from 7.7 to 1.5 cases/1000 patient discharges (36). Antibiotic control policies have also been associated with reducing the incidence of CDAD (7).…”

Section: Discussionmentioning

confidence: 99%

N‐CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N‐CDAD Prevalence Surveillance Project

Hyland

Ofner-Agostini²,

Miller

et al. 2001

Canadian Journal of Infectious Diseases and Medical Microbiolog

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BACKGROUND:A 1996 preproject survey among Canadian Hospital Epidemiology Committee (CHEC) sites revealed variations in the prevention, detection, management and surveillance ofClostridium difficile-associated diarrhea (CDAD). Facilities wanted to establish national rates of nosocomially acquired CDAD (N-CDAD) to understand the impact of control or prevention measures, and the burden of N-CDAD on health care resources. The CHEC, in collaboration with the Laboratory Centre for Disease Control (Health Canada) and under the Canadian Nosocomial Infection Surveillance Program, undertook a prevalence surveillance project among selected hospitals throughout Canada.OBJECTIVE:To establish national prevalence rates of N-CDAD.METHODS:For six weeks in 1997, selected CHEC sites tested all diarrheal stools from inpatients for eitherC difficiletoxin orC difficilebacteria with evidence of toxin production. Questionnaires were completed for patients with positive stool assays who met the case definitions.RESULTS:Nineteen health care facilities in eight provinces participated in the project. The overall prevalence of N-CDAD was 13.0% (95% CI 9.5% to 16.5%). The mean number of N-CDAD cases were 66.3 cases/100,000 patient days (95% CI

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Section: Discussionmentioning

confidence: 99%

N‐CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N‐CDAD Prevalence Surveillance Project

Hyland

Ofner-Agostini²,

Miller

et al. 2001

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…Personnel who contact patients with CDI can easily contaminate their hands with C. diffi cile spores. A prospective controlled trial of vinyl glove use for handling body substances showed a signifi cant decline in CDI rates from 7.7 per 1,000 discharges before institution of glove use to 1.5 cases per 1,000 discharges aft er institution of glove use ( P = 0.015) ( 180 ). Evidence that the use of gowns prevents spread of CDI is less compelling than that regarding the use of gloves, but gown use is recommended.…”

Section: Management Of CDI and Co-morbid Conditionsmentioning

confidence: 99%

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

Surawicz

Brandt

Binion

et al. 2013

American Journal of Gastroenterology

1,468

1,408

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Clostridium diffi cile infection (CDI) is a leading cause of hospital-associated gastrointestinal illness and places a high burden on our health-care system. Patients with CDI typically have extended lengths-of-stay in hospitals, and CDI is a frequent cause of large hospital outbreaks of disease. This guideline provides recommendations for the diagnosis and management of patients with CDI as well as for the prevention and control of outbreaks while supplementing previously published guidelines. New molecular diagnostic stool tests will likely replace current enzyme immunoassay tests. We suggest treatment of patients be stratifi ed depending on whether they have mild-to-moderate, severe, or complicated disease. Therapy with metronidazole remains the choice for mildto-moderate disease but may not be adequate for patients with severe or complicated disease. We propose a classifi cation of disease severity to guide therapy that is useful for clinicians. We review current treatment options for patients with recurrent CDI and recommendations for the control and prevention of outbreaks of CDI. Am J Gastroenterol 2013; 108:478-498; doi: 10.1038/ajg.2013 12. In patients in whom oral antibiotics cannot reach a segment of the colon, such as with Hartman's pouch, ileostomy, or colon diversion, vancomycin therapy delivered via enema should be added to treatments above until the patient improves. (Conditional recommendation, low-quality evidence)13. The use of anti-peristaltic agents to control diarrhea from confi rmed or suspected CDI should be limited or avoided, as they may obscure symptoms and precipitate complicated disease. Use of anti-peristaltic agents in the setting of CDI must always be accompanied by medical therapy for CDI. (Strong recommendation, low-quality evidence) Management of severe and complicated CDI14. Supportive care should be delivered to all patients and includes intravenous fl uid resuscitation, electrolyte replacement, and pharmacological venous thromboembolism prophylaxis. Furthermore, in the absence of ileus or signifi cant abdominal distention, oral or enteral feeding should be continued. 17. Vancomycin delivered orally (500 mg four times per day) and per rectum (500 mg in a volume of 500 ml four times a day) plus intravenous metronidazole (500 mg three times a day) is the treatment of choice for patients with complicated CDI with ileus or toxic colon and / or signifi cant abdominal distention. (Strong recommendation, low-quality evidence)18. Surgical consult should be obtained in all patients with complicated CDI. Surgical therapy should be considered in patients with any one of the following attributed to CDI: hypotension requiring vasopressor therapy; clinical signs of sepsis and organ dysfunction (renal and pulmonary); mental status changes; white blood cell count ≥ 50,000 cells / μ l, lactate ≥ 5 mmol / l; or failure to improve on medical therapy after 5 days. (Strong recommendation, moderate-quality evidence) Management of recurrent CDI (RCDI)19. The fi rst recurrence of CDI can be treated ...

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“…Inconclusive evidence has created confusion about appropriate hand hygiene during care of patients with CDI. Although in vivo studies show slight advantages for soap and water over ABHR, there are no clinical outcome studies suggesting the superiority of soap and water to ABHR for reducing CDI transmission; however, use of gloves has been associated with decreased CDI transmission, 146 suggesting that appropriate use of gloves should be emphasized over hand hygiene methods when targeting prevention of CDI via contact transmission. K. Hand preparation for surgery 1.…”

Section: Understanding the Incremental Clinical Benefit Of Tri-mentioning

confidence: 99%

Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene

Ellingson

Haas

Aiello

et al. 2014

Infect. Control Hosp. Epidemiol.

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Previously published guidelines provide comprehensive recommendations for hand hygiene in healthcare facilities. The intent of this document is to highlight practical recommendations in a concise format, update recommendations with the most current scientific evidence, and elucidate topics that warrant clarification or more robust research. Additionally, this document is designed to assist healthcare facilities in implementing hand hygiene adherence improvement programs, including efforts to optimize hand hygiene product use, monitor and report back hand hygiene adherence data, and promote behavior change. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

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Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission

Cited by 300 publications

References 24 publications

N‐CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N‐CDAD Prevalence Surveillance Project

N‐CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N‐CDAD Prevalence Surveillance Project

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene

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