Tarka Patryk, Hreczuch Wiesław, Chruściel Arkadiusz, Piotrowski Michał, Olczak-Pieńkowska Anna, Warda Karol, Rabczenko Daniel, Kanecki Krzysztof, Nitsch-Osuch Aneta
Department of Social Medicine and Public Health, Medical University of Warsaw, 02-106 Warsaw, Poland.
MEXEO, 47-225 Kedzierzyn-Kozle, Poland.
J Clin Med. 2025 Jul 10;14(14):4904. doi: 10.3390/jcm14144904.
: infection (CDI) is a major concern in hospital-acquired infections. spores can survive on surfaces for months and require sporicidal disinfection for elimination. The use of disinfectants should be based on laboratory-confirmed sporicidal activity, tested according to current standards in suspension and carrier tests. Further evaluation of disinfectant efficacy should occur in clinical settings by analyzing reductions in CDI incidence. This study aims to conduct a retrospective analysis of the impact of a new disinfection protocol and concurrent changes in antibiotic consumption on the incidence of healthcare-acquired CDI (HA-CDI). : This retrospective, single-center study assessed the impact of a chlorine dioxide-based disinfection protocol on HA-CDI across three periods: pre-intervention, intervention, and post-intervention. An interrupted time series analysis (ITS) with a Poisson distribution was used to evaluate the incidence of HA-CDI, while antibiotic consumption data were analyzed to identify any correlation with CDI infection rates. : Incidence Rate Ratio (IRR) before the intervention is 1.00, serving as the reference value. During the intervention period, the IRR is 0.79 (95% CI: 0.42-1.36; = 0.43), indicating a decrease in the incidence of infections compared to the pre-intervention period, although this result is not statistically significant. After the intervention, the IRR is 0.53 (95% CI: 0.26-0.97; = 0.057), suggesting a further reduction in the incidence of CDI; this result is on the borderline of statistical significance ( = 0.057), indicating a potential effect of the intervention, albeit without full statistical certainty. : The absence of a CDI surge despite increased antibiotic consumption highlights the synergistic relationship between antibiotic stewardship and rigorous infection control practices. The combination of the improved disinfection protocol and comprehensive staff training proved remarkably effective in mitigating CDI risk. Cleaning and disinfection in healthcare facilities is crucial for the prevention of healthcare-associated infections.
艰难梭菌感染（CDI）是医院获得性感染中的一个主要问题。孢子可在物体表面存活数月，需要使用杀孢子消毒剂来消除。消毒剂的使用应基于实验室确认的杀孢子活性，并根据当前悬浮液和载体试验标准进行测试。应通过分析CDI发病率的降低情况，在临床环境中对消毒剂的功效进行进一步评估。本研究旨在对一种新的消毒方案以及抗生素使用的同步变化对医疗保健相关CDI（HA-CDI）发病率的影响进行回顾性分析。：这项回顾性单中心研究评估了基于二氧化氯的消毒方案在三个时期对HA-CDI的影响：干预前、干预期和干预后。采用泊松分布的中断时间序列分析（ITS）来评估HA-CDI的发病率，同时分析抗生素使用数据以确定与CDI感染率的任何相关性。：干预前的发病率比（IRR）为1.00，作为参考值。在干预期间，IRR为0.79（95%置信区间：0.42 - 1.36；P = 0.43），表明与干预前相比感染发病率有所下降，尽管这一结果无统计学意义。干预后，IRR为0.53（95%置信区间：0.26 - 0.97；P = 0.057），表明CDI发病率进一步降低；这一结果处于统计学意义的临界值（P = 0.057），表明干预可能有效果，尽管没有完全的统计学确定性。：尽管抗生素使用增加，但CDI并未激增，这凸显了抗生素管理与严格感染控制措施之间的协同关系。改进的消毒方案与全面员工培训相结合，在降低CDI风险方面被证明非常有效。医疗机构中的清洁和消毒对于预防医疗保健相关感染至关重要。
