Improved hospital cleanliness combined with better hand-washing habits are the best route to cut Clostridium difficile (C.diff) infection rates, according to an article on the MD Magazine website.
An economic evaluation from Australia suggests that combining these efforts results in a larger decrease in C.diff cases than delivering them on their own. The cost of primary infection ranges from $3,400-$16,300 per case, while treating recurrent infection costs between $13,700–$18,000, the study said.
“The most effective approach to reducing C.diff transmission is to implement interventions in a bundled manner,” said the study’s lead author David Brain, PhD, MPH, a research fellow at the Australian Centre for Health Services Innovation, Queensland University of Technology, in Brisbane.
“Interest in cost-effectiveness analyses has spiked in recent years as healthcare decision-makers try to manage increased demand for services with a limited, and often reducing healthcare budget,” Brain said.
The study found that most hospitals employ a mixed approach that combines antimicrobial stewardship, hand hygiene, environmental cleaning and fecal bacteriotherapy. However, the researchers found a lack of economic evidence to support current practice.
“The majority of guidelines are built solely on clinical evidence, with no consideration of the costs and health returns from alternative strategies of infection control,’’ according to the researchers.
The most successful approach of the 10 the study examined combined better hand hygiene with improved environmental cleaning — a bundle the researchers called “hygiene improvement.” This strategy decreased disease incidence to 1.1 per 1000 bed days from 3.2 per 1000 bed days.