Shaking Up Clostidium Difficile Infections: Implementation of a Fecal Microbiota Transplant Program

Abstract

ISSUE: Recent studies demonstrated an increased risk of acquisition of MDR-Ab when patients are admitted to rooms that were previously occupied by patients who were positive for this pathogen. A cluster of 6 patients with healthcare-associated MDR-Ab was identified at our facility. Four of these patients were transferred from other healthcare facilities. In response, we instituted a comprehensive environmental hygiene program aimed at eliminating the risk of transmission of this pathogen. PROJECT: An interdisciplinary team implemented the following intervention plan: First, staff was educated on the significance of MDR-Ab, the importance of hand hygiene, and proper cleaning of equipment. Second, a process was initiated to ensure compliance with policies and procedures. In addition, a competency-based training programwas also instituted. Third, a new disinfectant was chosen for daily and terminal cleaning in isolation rooms. The disinfectant has a faster dwell time, which promoted compliance with the required drying time. It also offered an improved safety rating which instilled confidence in our staff. RESULTS: Surveillance data showed thatMDR-Abwas eliminated at our facility. The number of cases of MDR-Ab dropped to zero as of November 2012 (figure 1). Only one new case was identified since then (September 2013). Not surprisingly, the rate of methicillin resistant Staphylococcus aureus (MRSA) dropped significantly. As shown in figure 2, the rate of hospital admissions with MRSA Nosocomial Infection Marker (NIM) dropped from 0.67% in the third quarter 2012 to 0.25% in the 3rd quarter 2013.