Impact of targeted interventions on healthcare-acquired infection prevention and control of Clostridium difficile infections
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Background Clostridium difficile infection (CDI) is one of the major causative factors leading to antibiotic-associated hospital-acquired and infectious diarrhea. Because C. difficile spores can be transmitted between healthcare systems, healthcare workers have become a key target for preventing and controlling C. difficile infection. Methods We conducted a 6-month intervention and collected 776 patients with diarrhea and 72 cases with hospital-onset C. difficile infection (HO-CDI) in Xiangya Hospital’s intensive care units (ICU). We created a questionnaire on prevention and control knowledge of C. difficile infection, investigated the correctness of healthcare workers' answers before and after the training, statistically described the use of antimicrobial drugs, and judged the validity of this study as a result of the rates of C. difficile infection and morbidities in the three phases. Results The rates of three-stage C. difficile infection (13.3%vs.8.79%vs.6.5%) and morbidities rate/10,000 hospital days (117.14%vs.99.30%vs.71.63%) decreased gradually. After the training, the knowledge, attitude, and practice on prevention and control of C. difficile infection among healthcare workers were much improved. Among all diarrhea patients, there was a decreasing trend in the utilization of cefoperazone sulbactam (P < 0.001), imipenem (P = 0.047), tigecycline (P = 0.044) in all three phases, and an increase in cefoxitin (P < 0.001). There was no statistical difference between the three phases of antimicrobial utilization among hospital-onset C. difficile infection patients. Conclusions This study demonstrated that our training of healthcare workers on C. difficile infection was effective, enhancing healthcare workers' prevention and control awareness of C. difficile infection effectively reducing incidences and morbidities of C. difficile infection, and emphasizing the importance of healthcare workers in the healthcare process.
