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Reduction in Nosocomial Transmission of Drug‐Resistant Bacteria After Introduction of an Alcohol‐Based Handrub

Fred M. Gordin , MD, Maureen E. Schultz , RN, MSN, Ruth A. Huber , RN, MS and Janet A. Gill , RN, BSN
Infection Control and Hospital Epidemiology
Vol. 26, No. 7 (July 2005), pp. 650-653
DOI: 10.1086/502596
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Page Count: 4
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Reduction in Nosocomial Transmission of Drug‐Resistant Bacteria After Introduction of an Alcohol‐Based Handrub
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OBJECTIVE.  To assess quantitatively the clinical impact of using an alcohol‐based handrub (ABHR) in the hospital environment, measuring impact as the incidence of new, nosocomial isolates of drug‐resistant organisms. DESIGN.  An observational survey from 1998 to 2003 comparing the first 3 years of no ABHR use with the 3 years following, when an ABHR was provided for hand hygiene. SETTING.  An inner‐city, tertiary‐care medical center. INTERVENTION.  At baseline, an antimicrobial soap with 0.3% triclosan was provided for staff hand hygiene. The intervention was placement in all inpatient and all outpatient clinic rooms of wall‐mounted dispensers of an ABHR with 62.5% ethyl alcohol. Data were collected on change in the incidence of three drug‐resistant bacteria. RESULTS.  During the 6 years of the survey, all new, nosocomially acquired isolates of methicillin‐resistant Staphylococcus aureus (MRSA), vancomycin‐resistant Enterococcus (VRE), and Clostridium difficile–associated diarrhea were recorded. On comparison of the first 3 years with the final 3 years, there was a 21% decrease in new, nosocomially acquired MRSA (90 to 71 isolates per year; P = .01) and a 41% decrease in VRE (41 to 24 isolates per year; P < .001). The incidence of new isolates of C. difficile was essentially unchanged. CONCLUSION.  In the 3 years following implementation of an ABHR, this hospital experienced the value of reductions in the incidence of nosocomially acquired drug‐resistant bacteria. These reductions provide clinical validation of the recent CDC recommendation that ABHRs be the primary choice for hand decontamination.

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