caa a22 4500 388033126 CHVBK 20180307124957.0 cr unu---uuuuu 161130e199805 xx s 000 0 eng 10.1086/647824 doi S0195941700087610 pii (NATIONALLICENCE)cambridge-10.1086/647824 Reduction in Vancomycin-Resistant Enterococcus and Clostridium Difficile Infections Following Change to Tympanic Thermometers [Elektronische Daten] [Steven Brooks, Ashraf Khan, Dorin Stoica, Jennylyn Griffith, Les Friedeman, Rajat Mukherji, Rizwanullah Hameed, Nicole Schupf] OBJECTIVE: To contain a nosocomial outbreak of vancomycin-resistant Enterococcus (VRE). DESIGN: Intervention study, with comparison of incidence rates before and after intervention to assess whether changes in incidence followed the intervention and were greater than expected based on trends observed before the intervention. SETTING: A 343-bed acute-care hospital serving a predominantly elderly population referred from nursing homes, as well as patients admitted from the community. METHODS: Interventions strategies were tested on three high-risk nursing stations. These included enhanced environmental sanitation; intensive staff retraining in Universal Precautions, body substance isolation, and proper use of gloves; and the use of tympanic thermometers to avoid possible rectal or oral VRE transmission during temperature taking. RESULTS: Nosocomial VRE infections were reduced by 48% 9 months after switching to tympanic thermometers; incidence of Clostridium difficile infections also was reduced. As a result, tympanic thermometers were introduced facilitywide; additional observation for 20 months showed a risk reduction of 60% for VRE and 40% for C difficile. CONCLUSION: Cross-transmission of VRE and C difficile during temperature taking may result in bowel colonization, placing the patient at increased risk for infection. This risk may be reduced by the use of tympanic thermometers Copyright © The Society for Healthcare Epidemiology of America 1998 Brooks Steven Department of Laboratories, Kingsbrook Jewish Medical Center, Brooklyn, New York aut Khan Ashraf Department of Infection Control, Kingsbrook Jewish Medical Center, Brooklyn, New York Stoica Dorin Department of Infectious Disease, Kingsbrook Jewish Medical Center, Brooklyn, New York Griffith Jennylyn Department of Nursing, Kingsbrook Jewish Medical Center, Brooklyn, New York Friedeman Les Department of Pharmaceutical Services, Kingsbrook Jewish Medical Center, Brooklyn, New York Mukherji Rajat Department of Medicine, Kingsbrook Jewish Medical Center, Brooklyn, New York Hameed Rizwanullah Department of Infectious Disease, Kingsbrook Jewish Medical Center, Brooklyn, New York Schupf Nicole Laboratory of Epidemiology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York Infection Control & Hospital Epidemiology Cambridge University Press 19/5(1998-05), 333-336 0899-823X 19:5<333 1998 19 ICE https://doi.org/10.1086/647824 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1086/647824 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Brooks Steven Department of Laboratories, Kingsbrook Jewish Medical Center, Brooklyn, New York aut NATIONALLICENCE 700 1- Khan Ashraf Department of Infection Control, Kingsbrook Jewish Medical Center, Brooklyn, New York NATIONALLICENCE 700 1- Stoica Dorin Department of Infectious Disease, Kingsbrook Jewish Medical Center, Brooklyn, New York NATIONALLICENCE 700 1- Griffith Jennylyn Department of Nursing, Kingsbrook Jewish Medical Center, Brooklyn, New York NATIONALLICENCE 700 1- Friedeman Les Department of Pharmaceutical Services, Kingsbrook Jewish Medical Center, Brooklyn, New York NATIONALLICENCE 700 1- Mukherji Rajat Department of Medicine, Kingsbrook Jewish Medical Center, Brooklyn, New York NATIONALLICENCE 700 1- Hameed Rizwanullah Department of Infectious Disease, Kingsbrook Jewish Medical Center, Brooklyn, New York NATIONALLICENCE 700 1- Schupf Nicole Laboratory of Epidemiology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York NATIONALLICENCE 773 0- Infection Control & Hospital Epidemiology Cambridge University Press 19/5(1998-05), 333-336 0899-823X 19:5<333 1998 19 ICE CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge