Methods for infection control provided
by Mary Helen Yarborough
In their battle against an evolving army of germs, MUSC infection control experts may be outsmarting a battalion of tenacious microbes.
A couple of methods being used here to help shrink the rate of inpatient infections rely upon age-old practice: soap and water, and copper.
Microbiologist Michael Schmidt, Ph.D., helped illuminate MUSC's spot on the globe for his work on copper as a germ terminator in hospitals.
In fact, copper is so effective in killing nearly all infection-causing germs that it is being tested in several hospitals that are installing it on surfaces in operating rooms, patient rooms, and on surfaces where hands and germ-spreading vessels are likely to touch. It’s even being tested in air conditioning systems to stem the spread of toxic mold and other aerobic microbial contaminants.
“Copper is microbiocidal,” Schmidt said in an Ivanhoe Broadcasting segment that was picked up by hundreds of news outlets worldwide. “It’s a metal and when the bacteria come in contact with it, they die. [And] they are not coming back to life.”
Schmidt’s study involved replacing plastic components with copper in hospital rooms—nurse call buttons, bed rails, tray tables, keyboards and computer mouses.
While using copper may be expensive initially, the cost of hospital-acquired infections cost the nation’s health care system about $30 billion a year, said Schmidt. He is hoping to see copper cut infection rates by 50 percent.
Infectious disease expert Cassandra Salgado, M.D., said copper will add another much-needed layer of protection.
Copper is just one of the simple but highly effective measures being studied at MUSC. Soap is another.
Between 2001 and 2003, a virulent strain of Clostridium difficile (C-Diff) erupted into an endemic among American hospitals. The condition, called Clostridium difficile-associated disease (CDAD), is a particularly trouble-some emerging disease that is estimated to kill between 2 percent and 17 percent of those infected by it.
The majority, if not all, of these infections occur from inpatient stays and often are not discovered until after the patient is discharged—sending the sick patient back to the hospital.
“At least 20 percent of the population is colonized with C-Diff without any illness,” Salgado said. “The underlying risk factors for mortality in patients are having a compromised immune system or having a medical condition like kidney failure or diabetes.”
The problem is that C-Diff is unaffected by most antibiotics. In fact, attempting to treat an infection with antibiotics causes the C-Diff organism to explode.
Hand gels, which have become a staple of infection control, do not kill C-Diff or prevent the spread of the disease. Chlorine bleach is the best way to remediate areas contaminated by this tiny killer; and good old fashioned hand-washing with soap and water is the best way to prevent human-to-human spread of C-Diff, said Salgado.
“What makes hand washing more effective is the friction created that helps slough off the germs,” Salgado explained. “Hand gels kill a lot of germs, but they are not affective in killing C-Diff. And it doesn’t take much to spread this germ.”
When MUSC saw a spike in the CDAD infection rate in 2004, infection control and hospital staff moved quickly.
“When we had a patient that we suspected as having CDAD, we put them in isolation as a pre-emptive measure,” Salgado said.
MUSC hospital staff also were instructed to wash their hands with soap and water as opposed to total reliance on hand sanitizing gels. The swift policy change was made in all units in the adult hospital, Salgado said.
Since 2005, MUSC has instituted a policy of hand washing and pre-emptive patient isolation for those presenting with early signs of CDAD, primarily diarrhea.
Environmental Services is a critical component of the infection control team and assures that all rooms are scrubbed down with bleach, Salgado said.
During a five-to-six-month span, MUSC’s CDAD infection rate dropped back and below what is considered the national baseline, Salgado said.
“In 2004 and early 2005, the rate of CDAD was nearly five infections per 1,000 patient days with a mortality rate of about 3 percent,” Salgado said. “Now, we have less than one infection per 1,000 patient days.”
Friday, Aug. 29, 2008