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Reduction in Nosocomial Transmission of Drug-Resistant Bacteria After Introduction of an Alcohol-Based Handrub

Published online by Cambridge University Press:  21 June 2016

Fred M. Gordin ,
Maureen E. Schultz ,
Ruth A Huber  and
Janet A. Gill
Fred M. Gordin*
Affiliation:
Department of Medicine, George Washington University, Washington, DC
Maureen E. Schultz
Affiliation:
Veterans Affairs Medical Center, Washington, DC
Ruth A Huber
Affiliation:
Veterans Affairs Medical Center, Washington, DC
Janet A. Gill
Affiliation:
Veterans Affairs Medical Center, Washington, DC
*
Infectious Diseases (151B), VA Medical Center, 50 Irving Street NW, Washington, DC 20422.Fred.Gordin@med.va.gov
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Abstract

Objective:

To assess quantitatively the clinical impact of using an alcohol-based handrub (ABHR) in the hospital environment, measuring impact as the incidence of new, nosocomial isolates of drug-resistant organisms.

Design:

An observational survey from 1998 to 2003 comparing the first 3 years of no ABHR use with the 3 years following, when an ABHR was provided for hand hygiene.

Setting:

An inner-city, tertiary-care medical center.

Intervention:

At baseline, an antimicrobial soap with 0.3% triclosan was provided for staff hand hygiene. The intervention was placement in all inpatient and all outpatient clinic rooms of wall-mounted dispensers of an ABHR with 62.5% ethyl alcohol. Data were collected on change in the incidence of three drug-resistant bacteria.

Results:

During the 6 years of the survey, all new, nosocomially acquired isolates of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Clostridium difficile-associated diarrhea were recorded. On comparison of the first 3 years with the final 3 years, there was a 21% decrease in new, nosocomially acquired MRSA (90 to 71 isolates per year; P = .01) and a 41% decrease in VRE (41 to 24 isolates per year; P < .001). The incidence of new isolates of C. difficile was essentially unchanged.

Conclusion:

In the 3 years following implementation of an ABHR, this hospital experienced the value of reductions in the incidence of nosocomially acquired drug-resistant bacteria. These reductions provide clinical validation of the recent CDC recommendation that ABHRs be the primary choice for hand decontamination. (Infect Control Hosp Epidemiol 2005;26:650-653)

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 7 , July 2005 , pp. 650 - 653
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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