Dose-ranging study to assess the application of intranasal 2% mupirocin calcium ointment to eradicate Staphylococcus aureus nasal colonization.

Background: Mupirocin nasal ointment may be prescribed for decolonization prior to surgical procedures, especially for carriers of methicillin-resistant Staphylococcus aureus (MRSA). The approved regimen for decolonization of S. aureus from the anterior nares is twice daily for 5 d (10 doses).

Electronic surveillance for infectious disease trend analysis following a quality improvement intervention.

Objective: Interventions for reducing methicillin-resistant Staphylococcus aureus (MRSA) healthcare-associated disease require outcome assessment; this is typically done by manual chart review to determine infection, which can be labor intensive. The purpose of this study was to validate electronic tools for MRSA healthcare-associated infection (HAI) trending that can replace manual medical record review.

Design And Setting: This was an observational study comparing manual medical record review with 3 electronic methods: raw culture data from the laboratory information system (LIS) in use by our healthcare organization, LIS data combined with admission-discharge-transfer (ADT) data to determine which cultures were healthcare associated (LIS + ADT), and the CareFusion MedMined Nosocomial Infection Marker (NIM).

Laboratory testing for Clostridium difficile infection: light at the end of the tunnel.

Clostridium difficile infection (CDI) is changing as evidenced by increasing virulence, rising incidence, unresponsiveness to metronidazole therapy, and worse outcomes. Thus, it is critical that CDI diagnosis be accurate so ongoing epidemiology, disease prevention, and treatment remain satisfactory. We tested 10 diagnostic assays, including 1 commercial real-time polymerase chain reaction (qPCR) test for the laboratory detection of toxigenic C difficile on 1,000 stool samples.

Real-time detection of blaKPC in clinical samples and surveillance specimens.

A real-time PCR assay was developed targeting the bla(KPC) responsible for Klebsiella pneumoniae carbapenemase (KPC)-mediated carbapenem resistance and was validated for testing colonies or enrichment broth cultures. The assay accurately detects KPC-containing strains with high analytical specificity and sensitivity.

Significant impact of terminal room cleaning with bleach on reducing nosocomial Clostridium difficile.

Background: We were alerted to increased rates of Clostridium difficile-positive tests at all 3 hospitals in our health care system by MedMined Data Mining Surveillance Service, CareFusion (San Diego, CA). In response, an intervention of terminal room cleaning with dilute bleach was instituted to decrease the amount of C difficile environmental spore contamination from patients with C difficile infection (CDI).

Methods: The intervention consisted of replacing quaternary ammonium compound as a room cleaning agent with dilute bleach to disinfect rooms of patients with CDI upon discharge.