In 2009, officials at Jewish Hospital-Mercy Health knew they had a problem — its Clostridium difficile (C. diff) incidence rate had hit an all-time high of 25.27 per 10,000 patients and they didn’t know why.

“We had to do something,” says Jenny Martin, manager of quality administration.

The Cincinnati hospital convened a task force of clinical services professionals, physicians, nurses, administrators and environmental service workers to assess the spike in infections caused by this deadly bacterium, which ravages the intestines. They found that the patient makeup of the 209-bed hospital was partly to blame. C. diff is a bacterium that preys on the sick, particularly those who are elderly or immunocompromised — both of which Jewish Hospital-Mercy Health had plenty of.

“We have an older patient population — the average patient age is 72 years old — and we have a blood and bone marrow transplant center,” Martin says. “The type of antibiotics we use makes these patient populations very susceptible to C. diff infections.”

Hospital officials acted quickly and were able to slash the facility’s high C. diff rate by 50 percent in six months by standardizing care, adopting stricter antibiotic controls and incorporating new room-cleaning protocols.

“But in all honesty, the changes to our environmental cleaning practices had the most significant impact out of all of the changes we made,” says Martin.
As this example shows, when it comes to hospital-acquired infections custodial cleaning practices can make a world of difference.

What Is C. diff?

About 50 percent of the population naturally carries clostridium difficile (C. diff) in their intestines, states Benjamin Tanner, president of Antimicrobial Test Laboratories, Round Rock, Texas.

“It lives in harmony with the other bacteria in your intestines and doesn’t cause problems,” he says. “The only time it makes individual’s ill is when people go on multiple or individual antibiotic therapy.”

The bacteria, C. diff, exists within the body in a vegetative state and doesn’t make people sick, unless illness, disease and antibiotic use puts them at risk, Tanner explains. At that point, C. diff mutates into its active state, forming a resistant end spore that becomes difficult, if not impossible, to eradicate from the environment.

“These spores are exceedingly difficult and challenging to disinfect,” says Tanner. “Once they enter the environment, there are only a few disinfectants and technology that can kill it. The spores tend to get everywhere. They move easily from surface to surface.”

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