Reduction in the incidence of hospital-acquired Clostridium difficile infection through infection control interventions other than the restriction of antimicrobial use

A combination of infection control interventions, consisting of education, isolation, hand hygiene, contact precautions, and environmental disinfection, was implemented in the medical intensive care unit (MICU). The strict restriction of the use of antimicrobial agents was not included in this study. Following the interventions, the incidence of Clostridium difficile infection (CDI) in the MICU decreased significantly, by 67%, from 4.70 to 1.53 cases/1000 patient days (p = 0.012), while the hospital-wide incidence of CDI increased significantly from 0.93 to 1.17 cases/1000 patient-days (p = 0.021). A multifaceted approach to minimize C. difficile exposure can be effective in reducing the incidence of hospital-acquired CDI under conditions that do not allow for a restriction in the use of antimicrobial agents. (C) 2014 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).