Zafar A B, Gaydos L A, Furlong W B, Nguyen M H, Mennonna P A
Infection Control, Administration, Infectious Diseases, Pharmacy, Quality Assurance, Columbia Arlington Hospital, VA 22205, USA.
Am J Infect Control. 1998 Dec;26(6):588-93. doi: 10.1053/ic.1998.v26.a84773.
To report the effectiveness of use of comprehensive infection control measures to reduce the incidence of Clostridium difficile (CD) in an acute-care teaching hospital.
All CD infections were reviewed by the infection control coordinator from 1987 to 1996. The Centers for Disease Control and Prevention's nosocomial infection definition was used. CD-inclusion criteria remained unchanged during the study period. Interventions were started in 1990.
The interventions used were: (1) Isolation policy-revision and enforcement, which included universal precautions policy, (2) educational program-monthly to all health care workers, (3) phenolic disinfectant for environmental cleaning, (4) triclosan (0.03%) soap for handwashing, (5) centralization of sterilization department, (6) cart-washer installation, and (7) aggressive surveillance activity.
From 1987 to 1989, before the interventions, a total of 466 CD infections (mean 155 per year) occurred. From 1990 to 1996, after the interventions, 475 infections (mean 67 per year) occurred. Incidence of CD decreased by 60% from 1990 to 1996.
The sustained decrease of nosocomial CD during the 7-year period demonstrated the effectiveness of aggressive infection control measures that involve multiple disciplines.
报告在一家急症护理教学医院中，使用综合感染控制措施降低艰难梭菌（CD）感染发生率的效果。
感染控制协调员对1987年至1996年期间所有的CD感染进行了回顾。采用疾病控制与预防中心的医院感染定义。在研究期间，CD纳入标准保持不变。干预措施于1990年开始实施。
所采用的干预措施包括：（1）隔离政策的修订与执行，其中包括普遍预防措施政策；（2）每月对所有医护人员开展教育项目；（3）使用酚类消毒剂进行环境清洁；（4）使用含三氯生（0.03%）的肥皂洗手；（5）消毒部门集中化；（6）安装推车清洗机；（7）积极的监测活动。
在1987年至1989年干预措施实施前，共发生466例CD感染（平均每年155例）。在1990年至1996年干预措施实施后，发生475例感染（平均每年67例）。1990年至1996年，CD感染发生率下降了60%。
在这7年期间，医院内CD感染持续减少，证明了涉及多学科的积极感染控制措施的有效性。
