Lömskt och omfattande utbrott av Clostridium difficile. Ändrade städrutiner och täta utvärderingar halverade
infektionerna
Sammanfattning
Höglandssjukhuset, a hospital in Jönköping County, serves 110,000 people. By 2011, local laboratory data and health care associated infection data indicated that the hospital had a significant CDI problem compared to the county’s other two hospitals. Standards for monitoring CDI levels at the hospital level have not previously been established in Sweden. This local outbreak affected most hospital wards. Initiatives focused on room cleaning, diagnosis, and case-reporting started in June 2011 but failed to improve levels after 6 months. Further countermeasures were implemented starting in May 2012, with use of hypochlorite in a one-time hospital »deep clean« and its subsequent use as standard CD cleaning agent. Thereafter, a more than 50% sustained reduction of CDI levels (~10 cases/month) was noted as compared to corresponding monthly levels in 2011. Careful surveillance, cleaning with hypochlorite, and antibiotic stewardship initiatives comprise the continuing anti-CDI program.