Reduction in vancomycin-resistant Enterococcus and Clostridium difficile infections following change to tympanic thermometers

• Published in: Infection control and hospital epidemiology Vol. 19; no. 5; p. 333
• Main Authors: Brooks, S, Khan, A, Stoica, D, Griffith, J, Friedeman, L, Mukherji, R, Hameed, R, Schupf, N
• Format: Journal Article
• Language: English
• Published: United States 01.05.1998
• Subjects: Anti-Bacterial Agents - pharmacology; Clostridium difficile - drug effects; Cross Infection - epidemiology; Cross Infection - prevention & control; Cross Infection - transmission; Drug Resistance, Microbial; Enterococcus - drug effects; Enterocolitis, Pseudomembranous - epidemiology; Enterocolitis, Pseudomembranous - prevention & control; Enterocolitis, Pseudomembranous - transmission; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - prevention & control; Gram-Positive Bacterial Infections - transmission; Hospital Bed Capacity, 300 to 499; Hospitals, Community; Humans; Incidence; Poisson Distribution; Thermometers - microbiology; United States; Vancomycin - pharmacology; United States
• ISSN: 0899-823X
• DOI: 10.1086/647824

To contain a nosocomial outbreak of vancomycin-resistant Enterococcus (VRE). Intervention study, with comparison of incidence rates before and after intervention to assess whether changes in incidence followed the intervention and were greater than expected based on trends observed before the intervention. A 343-bed acute-care hospital serving a predominantly elderly population referred from nursing homes, as well as patients admitted from the community. Interventions strategies were tested on three high-risk nursing stations. These included enhanced environmental sanitation; intensive staff retraining in Universal Precautions, body substance isolation, and proper use of gloves; and the use of tympanic thermometers to avoid possible rectal or oral VRE transmission during temperature taking. Nosocomial VRE infections were reduced by 48% 9 months after switching to tympanic thermometers; incidence of Clostridium difficile infections also was reduced. As a result, tympanic thermometers were introduced facilitywide; additional observation for 20 months showed a risk reduction of 60% for VRE and 40% for C difficile. Cross-transmission of VRE and C difficile during temperature taking may result in bowel colonization, placing the patient at increased risk for infection. This risk may be reduced by the use of tympanic thermometers.