An environmental disinfection intervention to control Clostridium difficile

控制艰难梭菌的环境消毒干预措施

• 批准号: 8531882
• 负责人: Curtis Donskey
• 金额: $ 45.05万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2015-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8531882
• 关键词: environmental; disinfection; intervention; control; Clostridium

Contaminated surfaces are an important potential source for transmission of Clostridium difficile. However, interventions to improve environmental cleaning have not consistently been effective in reducing the incidence of C. difficile infection (CDI). Moreover, there is considerable uncertainty regarding optimal strategies to monitor the effectiveness of environmental disinfection. The goal of this application is to develop evidence-based strategies to improve environmental disinfection and to test their effectiveness in reducing rates of healthcare- associated CDI. Our central hypothesis is that an evidence-based intervention to improve environmental disinfection will reduce rates of healthcare-associated CDI. The specific aims of our proposal are: 1). Validate the effectiveness of the fluorescent marker method as a means to monitor disinfection of high-touch surfaces in CDI rooms. To accomplish this aim, we will correlate removal of fluorescent marker from high-touch surfaces in CDI rooms with removal of spores based on culture and PCR of toxin B genes. 2). Determine if daily disinfection of high- touch surfaces during CDI treatment will reduce healthcare worker hand contamination. To accomplish this aim, we will perform a prospective, randomized trial to compare standard cleaning (i.e., high-touch surfaces only cleaned if soiled) of CDI rooms versus standard cleaning plus daily decontamination of high-touch surfaces. The primary outcome measure will be healthcare worker hand contamination. and 3). Determine if an intervention to improve environmental disinfection by housekeeping staff will reduce rates of healthcare-associated CDI. To accomplish this aim, we will perform a 12-month randomized trial of 16 Cleveland area hospitals to compare standard housekeeping cleaning to enhanced cleaning with ongoing monitoring and feedback. The primary outcome measure will be incidence of healthcare- associated CDI. Our laboratory is ideally poised to accomplish the proposed research because we have extensive experience investigating the role of the environment in pathogen transmission and in evaluation of disinfection methods. The results will be significant because CDI is an important cause of morbidity and mortality and because there is a need for development of optimal environmental disinfection strategies to prevent transmission. The Department of Health and Human Services Action Plan to Prevent Healthcare-Associated Infections identified development and assessment of the impact of a Clostridium difficile environmental cleaning bundle as an important unmet need.

受污染的表面是艰难梭菌传播的重要潜在来源。 但是，改善环境清洁的干预措施并不一致地有效 在减少艰难梭菌感染的发生率（CDI）时。而且，有很多 关于监测环境有效性的最佳策略的不确定性 消毒。该应用的目的是制定基于证据的策略来改进 环境消毒并测试其在降低医疗保健率的有效性 相关的CDI。我们的核心假设是一种基于证据的干预措施来改善 环境消毒将降低与医疗保健相关的CDI的速度。具体目的 我们的建议是：1）。验证荧光标记方法的有效性 监视CDI房间中高接触表面的消毒。为了实现这一目标，我们将 将荧光标记物从CDI室中的高接触表面上移除与去除 基于毒素B基因培养和PCR的孢子。 2）。确定是否每天消毒高 - CDI治疗期间的触摸表面将减少医疗工人的手污染。到 实现这一目标，我们将执行一个预期的随机试验以比较标准 CDI房间与标准清洁 加上高点表面的每日净化。主要结果度量将是 医疗工人的手污染。和3）。确定是否有改善的干预措施 家政人员的环境消毒将降低与医疗保健相关的CDI的速度。 为了实现这一目标，我们将对16个克利夫兰地区进行12个月的随机试验 将标准家政清洁与正在进行的医院进行比较 监视和反馈。主要结果措施将是医疗保健的发生率 相关的CDI。理想情况下，我们的实验室可以完成拟议的研究，因为 我们有丰富的经验来研究环境在病原体中的作用 传播和评估消毒方法。结果将很重要，因为 CDI是发病率和死亡率的重要原因，因为需要 制定最佳环境消毒策略以防止传播。这 卫生与公共服务部行动计划，以防止医疗保健相关 感染确定了艰难梭菌的影响的发展和评估 环境清洁捆绑包是一个重要的未满足需求。

项目成果

Evaluation of a commercial real-time polymerase chain reaction assay for detection of environmental contamination with Clostridium difficile.

用于检测艰难梭菌环境污染的商业实时聚合酶链反应测定的评估。

• DOI: 10.1016/j.jhin.2013.06.011
• 发表时间: 2013
• 期刊: The Journal of hospital infection
• 作者: Deshpande,A;Kundrapu,S;Sunkesula,VCK;Cadnum,JL;Fertelli,D;Donskey,CJ
• 通讯作者: Donskey,CJ

Utility of an adenosine triphosphate bioluminescence assay to evaluate disinfection of Clostridium difficile isolation rooms.

使用三磷酸腺苷生物发光测定来评估艰难梭菌隔离室的消毒。

• DOI: 10.1086/671272
• 发表时间: 2013
• 期刊: Infection control and hospital epidemiology
• 影响因子: 4.5
• 作者: Deshpande,Abhishek;Sitzlar,Brett;Fertelli,Dennis;Kundrapu,Sirisha;Sunkesula,VenkataCK;Ray,AmyJ;Donskey,CurtisJ
• 通讯作者: Donskey,CurtisJ