Expanded efforts against C. diff haven't reduced infections: survey

Efforts to curb the spread of Clostridium difficile are increasing, yet are not having much of an effect on the infection rate for the intestinal superbug, according to a national survey of infection preventionists (PDF).

Sponsored by the Association for Professionals in Infection Control and Epidemiology, the survey showed that while 70% of infection preventionists have adopted additional practices to halt the spread of C. diff since March 2010, only 42% have experienced a decline in the infection rate. In fact, 43% have not noticed any improvement.

“We are encouraged that many institutions have adopted stronger measures to prevent” C. diff infections, Jennie Mayfield, APIC president-elect and clinical epidemiologist at Barnes-Jewish Hospital, St. Louis, said in a release. “But as our survey indicates, more needs to be done to reduce the spread of this infection.”

Mayfield expressed concern that staffing levels aren't sufficient to deal with C. diff. Only 21% of survey respondents said they had added infection prevention staff during the three-year period.

And although 92% of the 1,087 respondents said they had placed greater emphasis on environmental cleaning and equipment decontamination, 64% said they simply rely on observation to gauge cleaning effectiveness. Another 14% indicated they were doing nothing to monitor cleaning efforts.

“Because C. difficile spores can survive in the environment for many months, environmental cleaning and disinfection are critical to prevent the transmission of” C. diff infections, Mayfield said.

However, good news came in the form of increased antimicrobial stewardship programs. In 2010, 52% of survey participants had such programs in their facilities. Three years later, 60% of respondents do. Because antimicrobial use is one of the top risk factors for C. diff, these stewardship programs are especially vital in controlling the infection that kills 14,000 Americans each year.

The Centers for Disease Control and Prevention estimate that C. diff adds $1 billion to U.S. healthcare costs each year.

The APIC's 2013 C. diff infection Pace of Progress Survey was conducted online in January 2013 in order to evaluate the steps taken in U.S. healthcare facilities since March 2010 to prevent and control C. diff. APIC queried preventionists working in U.S. healthcare facilities, and 1,087 completed the survey. The results were presented March 11 at an APIC-hosted conference in Baltimore.