From the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (JW, JG, ML, MY, GG); and Virginia Tech Carilion School of Medicine, Roanoke, Virginia (JW).
Am J Phys Med Rehabil. 2021 Jan 1;100(1):44-47. doi: 10.1097/PHM.0000000000001579.
Clostridium difficile infection is a common hospital-associated infection spread via patient contact or contaminated environments. The risk for spread of C difficile may be greater in inpatient rehabilitation units than in some hospital units as patients are not confined to their rooms and often share equipment. Environmental disinfection is challenging in shared medical equipment, especially in equipment with complex designs. The study aimed to examine the presence of C difficile spores within an acute rehabilitation environment and to evaluate disinfection effectiveness.
Cultures were performed on 28 rehabilitation rooms, 28 rehabilitation floor surfaces, and 80 shared devices and equipment. Two disinfection interventions were implemented, and environmental cultures then were repeated postintervention.
Environmental cultures positive for CD spores were rehabilitation rooms (1/28), rehabilitation floors (13/28), and wheelchairs (3/20). After the implementation of new disinfection methods, repeat cultures were obtained and produced negative results.
Nonsporicidal disinfectant was not effective on hospital floors. Sporicidal disinfection of the floor is important when rates of C difficile infection are increased. Wheelchairs are complex devices and difficult to properly clean. The hospital purchased an ultraviolent device for wheelchair cleaning with a subsequent reduction in spores on repeat cultures.
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.
Upon completion of this article, the reader should be able to: (1) Recognize the impact of Clostridium difficile infections on the healthcare system; (2) Describe potential reservoirs of Clostridium difficile in the inpatient rehabilitation environment; and (3) Discuss interventions that may be implemented to reduce the reservoirs of Clostridium difficile on the rehabilitation unit.
Advanced.
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
艰难梭菌感染是一种常见的医院相关性感染，通过患者接触或污染的环境传播。与某些医院科室相比，住院康复病房中艰难梭菌的传播风险可能更高，因为患者不受限于病房，并且经常共用设备。在共享医疗设备中进行环境消毒具有挑战性，尤其是在设备设计复杂的情况下。本研究旨在检查急性康复环境中是否存在艰难梭菌孢子，并评估消毒效果。
对 28 个康复病房、28 个康复楼层表面和 80 个共享设备和设备进行培养。实施了两种消毒干预措施，然后在干预后重复进行环境培养。
环境培养结果阳性的有 CD 孢子的是康复病房（1/28）、康复地板（13/28）和轮椅（3/20）。实施新的消毒方法后，再次进行培养，结果为阴性。
非孢子杀菌剂对医院地板无效。当艰难梭菌感染率增加时，对地板进行孢子杀菌剂消毒很重要。轮椅是复杂的设备，难以正确清洁。医院购买了一种用于轮椅清洁的紫外线设备，随后在重复培养中减少了孢子。
要求 CME 学分：在 http://www.physiatry.org/JournalCME 上完成自我评估活动和评估。
CME 目标：完成本文后，读者应该能够：（1）认识到艰难梭菌感染对医疗保健系统的影响；（2）描述住院康复环境中艰难梭菌的潜在储库；（3）讨论可能实施的干预措施，以减少康复单元中艰难梭菌的储库。
高级。
学术物理治疗医师协会由继续教育医学认证委员会认可，为医生提供继续医学教育。学术物理治疗医师协会将此基于期刊的 CME 活动指定为最多 1.0 AMA PRA 类别 1 学分 ™。医生只能声称与他们参与活动的程度相符的学分。
