Friday, March 18, 2016

Whole Genome Sequencing and Clostridium difficile: New Insights

Like all US hospitals, we report C.difficile infection rates and compare ourselves to other institutions. Clostridium difficile infections are treated as healthcare associated infections but how are these best prevented? We still are not sure but new evidence is suggesting that the environment may play an increasingly important role.

By using whole genome sequencing, as reported in this paper, we have some new insights. In this study, the authors report that the majority (60%) of cases within an institution were circulated by ward-based contamination. Remarkable.

I believe in antibiotic stewardship programs to limit the unnecessary use antibiotics. This will help to decrease C.difficle risk hospital-wide. However, the environmental component must be aggressively tackled, this includes consistent hand hygiene with soap and water, rapid contact isolation of confirmed or suspected cases, meticulous bleach disinfection of rooms, and even (consider) using new technologies such as UVC robots (previously discussed here). 

Ongoing mechanisms must be in place to assess and feedback the completion of these infection prevention process measures otherwise best practices will falter.

Hospital not tackling the environmental component of C.difficile and other hospital acquired infections do so at their own peril. 

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