Japanese Society for Infection Prevention and Control-Online Journal

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Occurrence of Clostridium difficile Infection in our Hospital and its Control Measures

Kunihiko FUKUCHI¹⁾, Etsuko AKIMA²⁾, Kaori NAKANE³⁾, Kazuhisa UGAJIN³⁾, Sachiko TAHARA³⁾ and Yoshihito NIKI³⁾⁴⁾
¹⁾Department of Pathology, Showa University Hospital, ²⁾Division of Infection Control, Showa University East Hospital, ³⁾Division of Infection Control, Showa University Hospital, ⁴⁾Division of Clinical Infectious Diseases, Department of Medicine, Showa University Hospital

Clostridium difficile (CD) causes CD-associated diarrhea and often causes an outbreak due to horizontal transmission. The sensitivity and specificity of detection of a rapid enzyme immunoassay, which is usually used for detection of CD, was recently improved. We tried to improve the sensitivity of detection in CD by changing the examination method, and as a result, the diagnostic accuracy of CD-associated diarrhea improved. Despite the improvement of the sensitivity of detection, the spread of CD infection was observed. Next, we tried to improve the daily environmental cleaning. Conventionally, we used the wipes immersed in quaternary ammonium compounds for daily environmental cleaning, and when CD infection was confirmed, the environmental surface around the patients was disinfected with sodium hypochlorite. We introduced a complex-type chlorine-based disinfectant cleaner, which contains potassium peroxymonosulfate as the main component (RUBYSTA^Ⓡ, RST) in the ward of the main department of rheumatic disease and evaluated the effectiveness of the products for 2 years. As a result, we observed no horizontal transmission of CD after introduction of RST. It was suggested that the improvement of the detection methods of CD and environmental cleaning are effective in reduction of horizontal transmission of CD.

Key words：Clostridium difficile, antibiotic-associated diarrhea, CD toxin, potassium peroxymonosulfate

e-mail: kfukuchi＠med.showa-u.ac.jp

Received: October 27, 2016
Accepted: August 2, 2017

32 (6)：364─368,2017