Study: Copper-infused surfaces, linens could cut hospital-related infections
A new study suggests that copper-impregnated countertops, bed rails, and linens could play a role in reducing healthcare-associated infections (HAIs).
The study, published yesterday in the American Journal of Infection Control, was conducted at a community hospital in Virginia that had replaced a 1970s-era clinical wing with a new wing in 2013. Patient rooms and select patient care clinical areas in the new wing were outfitted with 16% copper oxide–impregnated composite countertops (including sinks, vanities, and nurse workstations), composite molded surfaces (over-the-bed tray tables and bed rails), and linens (bed sheets, blankets, patient gowns, and towels).
The materials for the new wing were chosen because contaminated environmental surfaces in hospitals have been recognized as a potential source of healthcare-associated pathogens that can be passed to patients by healthcare workers. Previous studies have demonstrated that copper has potent biocidal activity against a broad spectrum of microorganisms.
For the quasi-experimental study, researchers assessed the development and rate of HAIs due to multidrug-resistant organisms (MDROs) or Clostridium difficile in 72 rooms of the new wing and 84 rooms of an older hospital wing that were equipped with standard surfaces and lines. The assessment took place from March to December 2014. They then compared the results with the rate of HAIs observed at the hospital in the year leading up the opening of the new wing (November 2012 through November 2013).
Overall, 23,899 hospitalized patients were evaluated during the study, with 13,928 observed during the baseline period and 9,961 observed during the assessment period (5,527 patients in the old wing, and 4,704 in the new wing). HAI prevention measures were implemented consistently throughout the hospital between the baseline period and the assessment period, and equally in both the new and old wings during the assessment period.
In the final analysis, the researchers found that patients in the new hospital wing had 78% fewer HAIs due to MDROs or C difficile compared with the baseline period, 83% fewer C difficile infections overall, and 68% fewer infections due to MDROs. Patients in the old wing saw no change in HAI rates.
Although the results show only an association, the authors say the findings indicate that antimicrobial surfaces and linens may have substantial influence in reducing HAIs due to problematic MDROs.
Sep 28 Am J Infect Control study
Rapid molecular tests tied to improved outcomes in bloodstream infections
A meta-analysis of previously published studies has found that molecular rapid diagnostic testing (mRDT), when used in conjunction with an antibiotic stewardship program, is associated with improved clinical outcomes in bloodstream infections (BSIs).
The study, published this week in Clinical Infectious Diseases, looked at 31 studies involving 5,920 patients. The studies were evaluating the differences in clinical outcomes between mRDT and conventional microbiological methods for detecting organisms or resistance mechanisms, which have been used since the inception of microbiological sampling but are laborious and slow. The mRDT technologies included the following tests: polymerase chain reaction (PCR), matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS), and peptide nucleic acid fluorescent in situ hybridization (PNA-FISH).
The purpose of the study was to provide a comprehensive assessment of mRDT on mortality, time to effective therapy, and length of stay compared with conventional methods in patients with BSIs. Rapid diagnostic tests in theory can improve clinical outcomes by identifying bacterial infections quicker than conventional methods and reducing the amount of time to effective antibiotic therapy. That's why they are recommended under the National Action Plan for Combating Antibiotic-Resistant Bacteria. But widespread implementation has been limited because of high costs and limited outcomes data.
Overall, the researchers found that the risk of mortality was significantly lower with mRDT compared with conventional methods, but only in the presence of an antibiotic stewardship program. Significant decreases in mortality risk were observed with both gram-positive and gram-negative organisms, but not with yeast. In addition, mRDT was associated with decreased time to effective therapy and decreased length of stay.
Based on the clinical outcomes observed in the studies, the authors conclude that mRDT should be considered part of standard care for patients with BSIs.
Sep 26 Clin Infect Dis study