On the hands of patients with Clostridium difficile: A study of spore prevalence and the effect of hand hygiene on C difficile removal.

The prevalence of Clostridium difficile spores was assessed in 48 observations of infected inpatients. Participants were randomized to hand hygiene with either alcohol-based handrub or soap and water. C difficile was recovered in 14.

Nonimpact of Decolonization as an Adjunctive Measure to Contact Precautions for the Control of Methicillin-Resistant Staphylococcus aureus Transmission in Acute Care.

This was an observational study comparing methicillin-resistant Staphylococcus aureus (MRSA) transmission with no decolonization of medical patients to required decolonization of all MRSA carriers during two consecutive periods: baseline with no decolonization of medical patients (16 months) and universal MRSA carrier decolonization (13 months). The setting was a one-hospital, 156-bed facility with 9,200 annual admissions. Regression models were used to compare rates of MRSA acquisition.

Evaluation of multiple real-time PCR tests on nasal samples in a large MRSA surveillance program.

Objectives: We evaluated the LightCycler MRSA Advanced Test (Roche Molecular Diagnostics, Pleasanton, CA), the BD MAX MRSA assay (Becton Dickinson, Franklin Lakes, NJ), and the Xpert MRSA assay (Cepheid, Sunnyvale, CA) on nasal samples using the same population.

Methods: Admission and discharge nasal swabs were collected from inpatients using a double-headed swab. One swab was plated onto CHROMagar MRSA (CMA; Becton Dickinson, Sparks, MD) and then broken off into tryptic soy broth (TSB) for enrichment.

Active Surveillance and Decolonization Without Isolation Is Effective in Preventing Methicillin-Resistant Staphylococcus aureus Transmission in the Psychiatry Units.

Background: Control of methicillin-resistant Staphylococcus aureus (MRSA) is difficult in select populations. We used molecular typing to study the effect of universal surveillance and decolonization of carriers, without isolation, on MRSA transmission in a specialized unit.

Methods: Patients admitted to the unit were screened for nasal MRSA at admission and discharge.

Data requirements for electronic surveillance of healthcare-associated infections.

Electronic surveillance for healthcare-associated infections (HAIs) is increasingly widespread. This is driven by multiple factors: a greater burden on hospitals to provide surveillance data to state and national agencies, financial pressures to be more efficient with HAI surveillance, the desire for more objective comparisons between healthcare facilities, and the increasing amount of patient data available electronically. Optimal implementation of electronic surveillance requires that specific information be available to the surveillance systems.

The role of institutional epidemiologic weight in guiding infection surveillance and control in community and hospital populations.

Background: Institutions such as hospitals, prisons, and long-term care facilities have been identified as focal points for the transmission of emerging infections. Cost-effective control of these infections in large populations requires the identification of optimal subpopulations for targeted infection control interventions. Our objective was to quantify and compare the relative impact that individual institutions or subpopulations have on wider population-level outbreaks of emerging pathogens.

Patient colonization and environmental contamination by vancomycin-resistant enterococci in a rehabilitation facility.

Objectives: To determine the frequency of environmental contamination in patient and common-use rooms and patient colonization by vancomycin-resistant enterococci (VRE).

Design: Cross-sectional study.

Setting: A 146-bed rehabilitation facility.