Umemura T, Mutoh Y, Maeda M, Hagihara M, Ohta A, Mizuno T, Kato H, Sukawa M, Yamada T, Ikeda Y, Mikamo H, Ichihara T. Impact of Hospital Environmental Cleaning with a
Potassium Peroxymonosulphate-Based Environmental Disinfectant and Antimicrobial Stewardship on the Reduction of Hospital-Onset Clostridioides difficile Infections.
J Hosp Infect 2022;
129:181-188. [PMID:
35820556 DOI:
10.1016/j.jhin.2022.06.018]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND
A 1% potassium peroxymonosulphate-based environmental disinfectant (PPED) produces sodium hypochlorite when combined with sodium chloride, which functions as a disinfectant. However, little is known about the impact of hospital cleaning with PPED on hospital-onset Clostridioides difficile infection (HO-CDI).
AIM
To reduce HO-CDI, we promote antimicrobial stewardship and hospital ward cleaning with PPED. This study was conducted to evaluate their impact.
METHODS
We began a promotion of post-prescription review with feedback for broad-spectrum antimicrobials and hospital ward cleaning with PPED. We reviewed the ratio of HO-CDI, PPED consumption, and days of therapy (DOT) of broad-spectrum antimicrobials between July 2014 and March 2018, dividing this time into the pre-promotion (July 2014 to June 2015) and post-promotion periods (July 2015 to March 2018).
FINDINGS
Using interrupted time series analysis, an immediate significant change in HO-CDI was observed after intervention (P = 0.03), although a downward trend was not observed over this period (P = 0.19). Trends in PPED consumption significantly changed over this period (P = 0.02). DOT of carbapenems decreased immediately after the intervention began (P < 0.01). A Poisson regression analysis showed that PPED consumption and DOT of carbapenems were independent factors affecting HO-CDI (P = 0.039 and 0.016, respectively).
CONCLUSION
We revealed that DOT of carbapenems and use of PPED were associated with the HO-CDI ratio and that both interventions reduced the rate of HO-CDI. This is the first report on the impact of hospital ward cleaning with PPED on the reduction of HO-CDI.
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