C. the Difference with Steriplex

C. the difference with silver

Topic Significance & Study Purpose/Background/Rationale

The Blood and Marrow Transplant (BMT) patient population is highly susceptible to acquiring a Clostridium difficile (c. diff) infection. The prolonged neutropenic status causes c. diff infections to be more severe and longer lasting in this patient population (Rev Inst Med Trop Sao Paulo. 2014 Jul;56(4):325-31). On average, the cost of a Hospital Acquired Infection (HAI) of c.diff is $11,285 per incident (JAMA Intern Med 2013; 173(22)2039-2046). The current practice of sanitizing with bleach wipes with all patients has minimal effect on c.diff rates (Clin Infect Dis. (2000) 31 (4): 995-1000).

Methods, Intervention, & Analysis

Starting November 2013, the University of Minnesota Health Adult BMT unit experienced an increased prevalence of c. diff in the inpatient population. As a result, the unit switched their sanitizing practices to universally sanitizing with a hypochlorite solution. Previously, only rooms of patients testing positive for a c. diff infection were sanitized with a hypochlorite solution. This switch did not result in a significant drop in c.diff rates per one thousand patient days. In February, a silver based solution (Steriplex SD© & Steriplex 360©) was adopted unit wide to replace the hypoclorite solution. The use of all other sanitizing products were discontinued. C.diff rates were measured by patient lab reports.

Findings & Interpretation

Findings demonstrated that the switch to silver based wipes from bleach based wipes reduced c. diff infection rates among the BMT population, as demonstrated by the drop in the rate of active c.diff from 5.5/1000 patient days to 0/1000 patient days. The current hospital practice to reduce the transmission of active c.diff infection is the use of bleach based wipes. Implications of the study include: ongoing advocacy of improved infection prevention measures in the care of BMT patients, further conversations with the infection control department about c.diff infection control practices in the BMT population, as well as consideration for switching disinfection products hospital wide.

Discussion & Implications

On these finding, we have switched solely to sanitizing with the silver-based solution. We recommend the use of this solution to the outpatient BMT clinic. This practice would be beneficial in protecting all patient populations including those with hematological/oncological conditions.