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Saturday, June 7, 2008

C.diff the next superbug? Experts weigh hand sanitizers

Excerpt from recent article courtesy of, the publication serving the long term nursing care industry.

Prevention attention

Because MRSA and potentially other pathogens such as C. diff have spread beyond institutional walls and into the community, infection control professionals are on heightened alert to safeguard the vulnerable elderly and infirm populations.

“When it comes to the next pandemic, it is no longer a question of ‘if,' but ‘when,'” says Susan Duda-Gardiner, director of clinical services for the Illinois Council on Long-Term Care, on why hand hygiene is so integral to infection control.Duda-Gardiner said.

Could that pandemic be C. diff? The threat is real enough that APIC has launched a survey of infection control practitioners to determine its pervasiveness. The CDC reports that the number of states confirming the NAP1 C. diff strain jumped from 23 in February 2007 to 38 in November. While C. diff has been a longtime fixture on the long-term care scene, infection control professionals are concerned that its scope has spread and its toxicity is strengthening.

“The true magnitude of [C. diff] is still unknown,” APIC notes on its Web site. “Over the past 30 years, this pathogen has rapidly emerged as an important healthcare-associated infection, causing a spectrum of diseases, including diarrhea, colitis, toxic megacolon, sepsis and death. Other than the CDC's National Nosocomial Infections Surveillance data taken from approximately 250 hospital ICUs and patient discharge records, there are no national C. diff prevalence studies.”
Staff, resident and patient health is dependent upon hand hygiene compliance. Non-compliance places staff and residents at risk – it can ultimately lead to higher healthcare costs and could result in litigation.”

On the surface, hand washing seems like a rudimentary – almost innocuous – practice when compared to the complex nature of fortified germ breeds. Yet, as improbable as it might seem, cleansing with soap and water is nonetheless highly effective in stopping contagions cold.

“Regarding the spread of disease, we're talking about a multi-stage cycle – there is the microorganism itself, the mode of transmission, entry into a susceptible person and subsequent growth. Hand washing will cut off the infection at any point within that cycle,” Susan Duda-Gardiner, director of clinical services for the Illinois Council on Long-Term Care, on why hand hygiene is so integral to infection control.

Although soap and water cleansing may be the best method of hand washing, in reality, it can be difficult for busy workers to find a sink after every encounter. That is why hand sanitizers have become a popular and effective substitute, Duda-Gardiner said.

“Hand sanitizers are actually fairly new to the long-term care industry and they are phenomenal,” she said. “While soap and water is preferred – especially for C. diff — the sanitizers are great because of their portability and convenience. You can carry a bottle around in your pocket so that you can use it after every resident contact.”

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