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Reduction in Vancomycin-Resistant Enterococcus and Clostridium Difficile Infections Following Change to Tympanic Thermometers

Published online by Cambridge University Press:  02 January 2015

Steven Brooks ,
Ashraf Khan ,
Dorin Stoica ,
Jennylyn Griffith ,
Les Friedeman ,
Rajat Mukherji ,
Rizwanullah Hameed  and
Nicole Schupf
Steven Brooks*
Affiliation:
Department of Laboratories, Kingsbrook Jewish Medical Center, Brooklyn, New York
Ashraf Khan
Affiliation:
Department of Infection Control, Kingsbrook Jewish Medical Center, Brooklyn, New York
Dorin Stoica
Affiliation:
Department of Infectious Disease, Kingsbrook Jewish Medical Center, Brooklyn, New York
Jennylyn Griffith
Affiliation:
Department of Nursing, Kingsbrook Jewish Medical Center, Brooklyn, New York
Les Friedeman
Affiliation:
Department of Pharmaceutical Services, Kingsbrook Jewish Medical Center, Brooklyn, New York
Rajat Mukherji
Affiliation:
Department of Medicine, Kingsbrook Jewish Medical Center, Brooklyn, New York
Rizwanullah Hameed
Affiliation:
Department of Infectious Disease, Kingsbrook Jewish Medical Center, Brooklyn, New York
Nicole Schupf
Affiliation:
Laboratory of Epidemiology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York Gertrude H. Sergievsky Center, Columbia University School of Medicine, New York City, New York
*
Microbiology, Kingsbrook Jewish Medical Center, David Minkin Rehabilitation Institute, 585 Schenectady Ave, Brooklyn, NY 11203-1891
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Abstract

OBJECTIVE: To contain a nosocomial outbreak of vancomycin-resistant Enterococcus (VRE).

DESIGN: Intervention study, with comparison of incidence rates before and after intervention to assess whether changes in incidence followed the intervention and were greater than expected based on trends observed before the intervention.

SETTING: A 343-bed acute-care hospital serving a predominantly elderly population referred from nursing homes, as well as patients admitted from the community.

METHODS: Interventions strategies were tested on three high-risk nursing stations. These included enhanced environmental sanitation; intensive staff retraining in Universal Precautions, body substance isolation, and proper use of gloves; and the use of tympanic thermometers to avoid possible rectal or oral VRE transmission during temperature taking.

RESULTS: Nosocomial VRE infections were reduced by 48% 9 months after switching to tympanic thermometers; incidence of Clostridium difficile infections also was reduced. As a result, tympanic thermometers were introduced facilitywide; additional observation for 20 months showed a risk reduction of 60% for VRE and 40% for C difficile.

CONCLUSION:Cross-transmission of VRE and C difficile during temperature taking may result in bowel colonization, placing the patient at increased risk for infection. This risk may be reduced by the use of tympanic thermometers

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 5 , May 1998 , pp. 333 - 336
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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