RESUMO
OBJECTIVE: To model the effects of active detection and isolation (ADI) regarding Clostridioides difficile infection (CDI) in the bone marrow transplant (BMT) unit of our hospital. SETTING: ADI was implemented in a 21-patient bone marrow unit. PATIENTS: Patients were bone marrow recipients on this unit. INTERVENTIONS: We compared active ADI, in which patients who tested positive for colonization of C. difficile before their hospital stay were placed under extra contact precautions, with cases not under ADI. RESULTS: Within the BMT unit, ADI reduced total cases of CDI by 24.5% per year and reduced hospital-acquired cases by â¼84%. The results from our simulations also suggest that ADI can save â¼$67,600 per year in healthcare costs. CONCLUSIONS: Institutions with active BMT units should consider implementing ADI.
Assuntos
Clostridioides difficile , Infecções por Clostridium , Infecção Hospitalar , Humanos , Transplante de Medula Óssea/efeitos adversos , Clostridioides difficile/isolamento & purificação , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/epidemiologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/epidemiologia , Controle de Infecções/métodos , Unidades HospitalaresRESUMO
BACKGROUND: Multiple studies have shown that bathing with chlorhexidine gluconate (CHG) wipes reduces hospital-acquired infections (HAIs). We employed a mathematical model to assess the impact of CHG patient bathing on central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and hospital-onset Clostridium difficile (C diff) infections and the associated costs. METHODS: Using a Markov chain, we examined the effect of CHG bathing compliance on HAI outcomes and the associated costs. Using estimates from 2 different studies on CHG bathing effectiveness for CLABSI, CAUTI, and C diff, the number of HAIs per year were estimated along with associated costs. The simulations were conducted, assuming CHG bathing at varying compliance rates. RESULTS: At 32% reduction in HAI incidence, increasing CHG bathing compliance from 60% to 90% results in 20 averted infections and $815,301.75 saved cost. CONCLUSIONS: As CHG bathing compliance increases, yearly HAIs decrease, and the overall cost associated with the HAIs also decreases.