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Despite Increased Monitoring Efforts, Spread of Superbug Still Occurs in Medical Facilities

March 12, 2013
by Rajiv Leventhal
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While facilities have increased activities to stop the spread of the intestinal superbug Clostridium difficile, those efforts are not yielding large improvements, according to a nationwide survey of infection preventionists released by the Association for Professionals in Infection Control and Epidemiology (APIC).

According to the new survey, 70 percent of infection preventionists have adopted additional interventions in their healthcare facilities to address C. difficile infection (CDI) since March 2010, but only 42 percent have seen a decline in their healthcare facility-associated CDI rates during that time period; 43 percent have not seen a decline. While CDI rates have climbed to all-time highs in recent years, few facilities (21 percent of respondents) have added more infection prevention staff to address the problem.  

APIC conducted the 2013 CDI Pace of Progress survey in January 2013 to assess activities that have been implemented in U.S. healthcare facilities in the last three years to prevent and control CDI, a healthcare-associated infection that kills 14,000 Americans each year. A total of 1,087 APIC members completed the survey which was intended to provide a general overview of trends and indicate areas where more in-depth research might be beneficial.

“We are encouraged that many institutions have adopted stronger measures to prevent CDI, but as our survey indicates, more needs to be done to reduce the spread of this infection,” Jennie Mayfield, APIC president-elect and clinical epidemiologist at Barnes-Jewish Hospital, said in a statement. “We are concerned that staffing levels are not adequate to address the scope of the problem.”

The Pace of Progress survey also noted an inconsistency between cleaning efforts and monitoring. More than nine in 10 respondents (92 percent) have increased the emphasis on environmental cleaning and equipment decontamination practices since March 2010, but 64 percent said they rely on observation, versus more accurate and reliable monitoring technologies to assess cleaning effectiveness. Fourteen percent said that nothing was being done to monitor room cleaning. 

According to the survey, antimicrobial stewardship programs are slowly increasing. Sixty percent of respondents have antimicrobial stewardship programs at their facilities, compared with 52 percent in 2010. Because antimicrobial use is one of the most important risk factors for CDI, stewardship programs that promote judicious use of antimicrobials should be encouraged. 

According to the Centers for Disease Control and Prevention, deaths related to CDI increased 400 percent between 2000 and 2007, due in part to a stronger germ strain. CDI is estimated to add at least $1 billion annually to U.S. healthcare costs.

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