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From the Desk of Mary Bennett, RN, CIC
The New Clostridium difficile: Pathogenicity, Complications, Prevention.
This is the title of our complimentary webinar offered this month on February 15th. We are honored that Dr. Wava Truscott has agreed to return to speak on this subject after enlightening us this past month on the extremely interesting topic of biofilms.
About This Webinar:
Clostridium difficile infection is recognized as one of the most serious healthcare-associated infections occurring around the world today. Infections may be mild and resolve fairly rapidly after antibiotic cessation, or may be severe, lingering, recurring and life-threatening. Emergence of new strains with increased virulence, sporulation frequency and antibiotic resistance along with increased patient vulnerabilities, altered healthcare practices and new reservoirs are all contributing to the aggressive success of this not-so-glamorous superbug.
The purpose of this educational program is to discuss the impact of Clostridium difficile, describe its new strains, recommend best practices for Ambulatory Surgery Centers and describe new technologies designed to prevent transmission.
Learner Objectives:
Upon completion of this continuing education activity, the participant should be able to:
- Identify conditions that make C. difficile a successful pathogen
- List complications associated with infections (CDI)
- Discuss reservoirs for nosocomial transmission
- Describe best practices for transmission prevention
Click on our Complimentary webinar link below.
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Complimentary Webinar-2/15/2012-Sponsored by:
Infection Control Management by Excellentia
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Greetings ASC Administrator or Directors!
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| Bug of the Month: Clostridium tetani |
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We recently began to explore the genus of bacteria known as Clostridium. Bacteria in this genus are rod shaped, gram positive, and form endospores. Clostridia are found in anaerobic habitats such as soil, aquatic sediments and the intestinal tracts of humans and animals. They usually do not grow under aerobic conditions. Because they release potent toxins and form spores which can persist in the environment for long periods of time, some Clostridia have serious consequences for humans. Over the next few months, we will look at the species of Clostridia that may have an impact in our work environments, C. difficile, C. perfringens, and C. tetani. Clostridium tetani is the third species of organisms within this genus we will explore.
Click to read more...
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Click Here to Read More on Clostridia tetani |
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| Question from Our Last Infection Control Webinar |
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Who should do the TB Testing?
There have been questions and discussions about TB testing. The correct administration of a Tuberculin Skin Test and interpreting the results require skill. The validity TB skin testing is dependent on correct intradermal administering the tuberculin solution and results interpretation. Frequently, in a small facility, the testing is performed by the Infection Preventionist or the Employee Health Nurse. Training of the person(s) who will be performing tuberculin skin testing at your facility is essential.
State Health Departments have a tuberculosis manual on their website that contains explicit and detained instructions about administering the tests and interpreting results. Some states may require a training course and a passing an exam before being allowed to perform TB Testing.
The CDC has resources for training including the core curriculum for TB, a training DVD for mantoux testing and a helpful wall chart. You can find the resources and the ordering information here:
http://www.cdc.gov/tb/education/Mantoux/default.htm
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| Where did you find that information? |
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Where did you find that information?
Have you had difficulty in finding certain Infection Control related information on the internet? Look no further, we have already searched for them and will provide a few links each month to help you find websites and information you need. Bookmarking information sources is always a good idea so you can find them easily when necessary.
Where do I find standardized surveillance definitions for infections?
http://www.cdc.gov/nhsn/PDFs/pscManual/17pscNosInfDef_current.pdf
Where can I find the EPA's list of registered disinfectants?
The EPA has 9 lists of registered disinfectants, they can be found here:
http://www.epa.gov/oppad001/chemregindex.htm
At this time, the EPA does not have a list of registered disinfectants approved to destroy C. difficile spores.
Where can I find the CMS interpretive guidelines for Ambulatory Surgery Centers?
This is the State Operations Manual that contains the interpretive guidelines, you will find it with the 2011 revisions here:
http://www.cms.gov/manuals/Downloads/som107ap_l_ambulatory.pdf
If there are other sources you need, please e-mail me at mary@excellentiagroup.com I will include them in future newsletters. If you need a resource for information before the next newsletter, please contact me.
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| Privacy Curtains (updated) |
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We continue to see questions about privacy curtains and particularly how often they should be changed and laundered.
Privacy curtains are part of our patient's immediate environment. They are often considered to be a high touch surface and they are handled by both employees and by patients. The persons who touch the curtains may or may not be touching them with clean hands. Because of these factors, there is a risk of microbial contamination of the curtains, especially the edges which are most frequently handled. Direct contact is not the only mechanisms of contamination of fabrics in the health care setting; they can also become contaminated by respiratory droplets. The ability of micro-organisms to remain alive in the environment is a factor in their ability to be transmitted. Studies have been done measuring the persistence of live bacteria on various fabrics in health care settings.
One study tested microbial survival on several materials which included 100% cotton, clothing; 100% cotton terry, towels and washcloths; 60/40% cotton/polyester blend, scrub suits, lab coats, and clothing; 100% polyester, privacy curtains and clothing; and 100% polyethylene plastic, splash aprons. The results of the study:
- Staphylococci survived at least one day on all fabrics and plastics with the longest viability on polyester 1-56 days, and polyethylene plastic 22-90 days.
- Enterococci: the shortest survival time was 11 days, with longer times on polyester and polyethylene plastic. The enterococci tended to live longer than staphylococci
That means these organisms can live for days or months on fabrics commonly worn by patients and employees and fabrics that are part of the health care environment. This article made note that the polyester fabric used in the study was the material used in their privacy drapes.
The presence of visible soiling or contamination with blood, body fluids or other potentially infectious materials requires immediate change of the curtains. Privacy curtains should be changed if the patient has been on droplet or contact precaution. In the absence of visible soiling, known or suspected contamination, there are no specific recommended time intervals between curtain changes. The facility should establish and follow a schedule for the changing and laundering of its privacy curtains. This could for example be done monthly, quarterly, every 6 months or at a minimum yearly. Of course, this should be documented.
There have been concerns voiced by some about the cost regularly scheduled laundering and changing of the privacy curtains. Associated costs would be staff time to take down and put up curtains, utility, and laundering costs. This is understandable since the curtains are large and laundry facilities may charge for laundering by the pound. It may be feasible to use disposable privacy curtains. Some of these disposable curtains can be quickly and easily changed saving cost, and laundering is not a cost associated with their use. Many of the disposable curtains are biodegradable and are environmentally friendly. An internet search found many suppliers of these products. Some can be used with existing tracks and some require tracks from the manufacturer.
There are no specific requirements for the frequency of changing and laundering privacy curtains in the absence of contamination and soiling. The facility should establish and follow its schedule for changing the curtains. Because of differing needs, the frequency of laundering/changing curtains will vary from facility to facility. Contaminated and/or visibly soiled privacy curtains should be changed immediately. If the patient has been on droplet or contact precautions, the privacy curtains should be changed. Use of disposable privacy curtains may prove to be convenient and has the potential for cost savings.
Resource: Journal of Clinical Microbiology, Feb. 2002 p. 724-72 6 Survival of Enterococci and Staphylococci on Hospital Fabrics and Plastic; Alice Neely and Mathew P. Maley; Shriners Hospitals for Children and Department of Surgery University of Cincinnati College of Medicine, Cincinnati, Ohio http://idsint.net/wp-content/uploads/2011/02/Survival-of-bacteria-on-Hospital-textiles.pdf
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