Interventions Improve Cleaning of C. difficile Isolation Rooms
(HealthDay News) – An enhanced protocol for the standard disinfection of hospital rooms after discharge of patients with Clostridium difficile infection (CDI), which includes a dedicated team for daily disinfection and a standardized process for clearing cleaned rooms, results in consistent disinfection, according to research published in the May issue of Infection Control and Hospital Epidemiology.
Brett Sitzlar, of the Case Western Reserve University School of Medicine in Cleveland, and colleagues prospectively evaluated three sequential, tiered interventions for cleaning and disinfecting CDI hospital rooms that were enacted during a 21-month period in a Veterans Affairs hospital. The first intervention was use of fluorescent markers applied to 14 high-touch surfaces in patient rooms, with cleaning thoroughness assessed on the basis of marker removal. The second intervention was use of an automated ultraviolet radiation device as an adjunct for disinfection. The third intervention was enhanced standard disinfection using a dedicated daily team and a standardized process for assessing and clearing rooms after cleaning and disinfection.
The researchers found that use of fluorescent markers significantly improved the thoroughness of cleaning of high-touch surfaces. Compared with baseline, the prevalence of positive C. difficile cultures from CDI rooms was significantly reduced by 14% for the first, 48% for the second, and 89% for the third intervention. At baseline, 67% of CDI rooms had positive cultures for C. difficile after disinfection. The percentages of CDI rooms with positive cultures following disinfection were reduced to 57%, 35%, and 7% for the first, second, and third interventions, respectively.
"Ultimately, disinfection was dramatically improved through formation of a dedicated daily disinfection team and implementation of a standardized process for clearing CDI rooms," the authors write. "Our experience suggests that culturing of CDI rooms after terminal cleaning could provide a valuable means to assess the effectiveness of cleaning interventions."