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Significant reduction in vancomycin-resistant enterococcus colonization and bacteraemia after introduction of a
E A Grabsch1, A A Mahony, D R M Cameron
1Microbiology Department, Austin Health, Heidelberg, Victoria, Australia.
The Journal of Hospital Infection
|October 30, 2012
Summary
A hospital-wide bleach-based cleaning program significantly reduced vancomycin-resistant enterococcus (VRE) colonization and bloodstream infections. This multi-modal approach improved patient outcomes and environmental hygiene in high-risk settings.
Area of Science:
- Infection Control and Hospital Epidemiology
- Antimicrobial Resistance
- Environmental Hygiene
Background:
- Rising rates of vancomycin-resistant enterococcus (VRE) infections and colonization pose a significant challenge in healthcare settings.
- Standard VRE control guidelines have shown limited efficacy in curbing VRE transmission.
- Increased VRE necessitates innovative strategies to enhance infection prevention and control measures.
Purpose of the Study:
- To evaluate the effectiveness of a multi-modal, hospital-wide improvement program, termed 'Bleach-Clean', in reducing VRE.
- To assess the impact of the program on VRE colonization, infection, and environmental contamination.
- To compare VRE rates and environmental contamination before and after the implementation of the Bleach-Clean program.
Main Methods:
- Implementation of a bleach-based cleaning-disinfection program using sodium hypochlorite (1000 ppm) and detergent.
- Standardized cleaning-disinfection practices, supervised by dedicated personnel.
- Modified protocols incorporating alcohol-based hand hygiene and sleeveless aprons, replacing gowns and gloves.
Main Results:
- Significant reduction in new VRE colonizations by 24.8% (P = 0.001) and environmental contamination by 66.4% (P = 0.012).
- Overall VRE bacteraemia decreased by 83.1% (P < 0.001) hospital-wide.
- The total burden of VRE in high-risk wards also declined, indicating a reduced VRE patient population.
Conclusions:
- The 'Bleach-Clean' program effectively reduced VRE colonization and hospital-acquired bloodstream infections.
- This multi-modal intervention demonstrates significant potential for VRE control in endemic healthcare environments.
- Findings support the adoption of enhanced environmental cleaning and modified protocols to combat VRE spread.
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