PURPOSE: Treatment of multi-drug resistant organism (MDRO) infection is an enormous burden to the health care system. Hand hygiene is a fundamental component of infection control in the intensive care setting. Few studies have examined the effect of hand hygiene on rates of MDRO infection.
METHODS: Prospectively-collected data were examined retrospectively from our infection control databases during a 33-month hand hygiene task force. Rates of methicillin-resistant S. aureus (MRSA), C. difficile (CD), and vancomycin-resistant enterococcus (VRE) were calculated based on infections per 1000 patient days in the surgical intensive care unit (SICU). Hand hygiene was estimated by measuring product consumption. Our institution is an urban academic level 1 trauma center with 2 SICUs.
RESULTS: Hand sanitizer use increased by 409% during the study period while hand soap use did not change significantly. At the same time, overall MDRO infection decreased significantly, from 4.49 to 2.47 MDRO infections/1000 patient days. MRSA decreased significantly from 3.37 to 1.04 MRSA infections/1000 patient days. CD did not change significantly from baseline, from 0.75 to 0.52 CD infections/1000 patient days. VRE infection rates were low throughout the study and did not change significantly, from 0.37 to 0.91 VRE infections/1000 patient days.
CONCLUSION: Improved hand sanitizer use in the SICU was associated with reduced incidence of MDRO infection, notably MRSA. CD infection did not decrease significantly because hand soap use, which is required to destroy Clostridium spores, did not improve during the task force.
CLINICAL IMPLICATIONS: Improved hand hygiene in the SICU can reduce MDRO infection. An effective hand hygiene task force should emphasize hand soap use in addition to hand sanitizer.
DISCLOSURE: Dorothy Bird, No Financial Disclosure Information; No Product/Research Disclosure Information