caa a22 4500 388035234 CHVBK 20180307125002.0 cr unu---uuuuu 161130e199807 xx s 000 0 eng 10.1086/647855 doi S019594170008807X pii (NATIONALLICENCE)cambridge-10.1086/647855 A Randomized Crossover Study of Disposable Thermometers for Prevention of Clostridium difficile and Other Nosocomial Infections [Elektronische Daten] Abstract OBJECTIVE: To test the hypothesis that use of disposable thermometers would result in lower rates of nosocomial Clostridium difficile diarrhea and of total nosocomial infections, compared with electronic thermometers. DESIGN: Prospective randomized crossover trial. SETTING: A 700-bed university hospital providing primary and tertiary care. PATIENTS: All patients admitted to a group of 20 inpatient nursing units. INTERVENTIONS: 20 nursing units were randomized into two groups. One group randomly was assigned exclusive use of single-use disposable thermometers for patient temperature measurement, and the other group was assigned exclusive use of electronic thermometers. After 6 months, the assignments were reversed. MAIN OUTCOME MEASURES: Rates of C difficile infections, total nosocomial diarrheal episodes, and total nosocomial infections were prospectively followed in each study unit over 11 months. RESULTS: 26,350 patients were admitted to the study units and hospitalized for 120,529 patient days. There were 947 nosocomial infections (7.86 per 1,000 patient days). Nosocomial C difficile- associated diarrhea defined by positivity to both toxin B (titer ≥1:10) and toxin A was detected in 32 patients (3.4% of all nosocomial infections). A significantly lower rate of nosocomial C difficile-associated diarrhea was observed with disposable thermometer use (0.16 per 1,000 patient days) compared with electronic thermometer use (0.37 per 1,000 patient days, relative risk [RR]=0.44; 95% confidence interval [CI95], 0.21-0.93, P=.026). There was no difference in overall rates of nosocomial infection between the disposable and electronic groups (8.03 and 7.68 infections per 1,000 patient days, respectively; RR, 1.04; CI95, 0.92-1.19; P=.52) or in the overall rate of nosocomial diarrhea (3.34 and 3.40 per 1,000 patient days, respectively; RR, .98; CI95, 0.81-1.19; P=.87). CONCLUSIONS: The incidence of nosocomial C difficile diarrhea was reduced significantly by using single-use, disposable thermometers as compared with electronic thermometers, but there was no effect on either the overall rate of nosocomial diarrhea or the rate of total nosocomial infections. Copyright © The Society for Healthcare Epidemiology of America 1998 Jernigan John A. University of Virginia Health Sciences Center, Charlottesville, Virginia Siegman-Igra Yardena University of Virginia Health Sciences Center, Charlottesville, Virginia Guerrant Richard C. University of Virginia Health Sciences Center, Charlottesville, Virginia Farr Barry M. University of Virginia Health Sciences Center, Charlottesville, Virginia Infection Control & Hospital Epidemiology Cambridge University Press 19/7(1998-07), 494-499 0899-823X 19:7<494 1998 19 ICE https://doi.org/10.1086/647855 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1086/647855 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jernigan John A. University of Virginia Health Sciences Center, Charlottesville, Virginia NATIONALLICENCE 700 1- Siegman-Igra Yardena University of Virginia Health Sciences Center, Charlottesville, Virginia NATIONALLICENCE 700 1- Guerrant Richard C. University of Virginia Health Sciences Center, Charlottesville, Virginia NATIONALLICENCE 700 1- Farr Barry M. University of Virginia Health Sciences Center, Charlottesville, Virginia NATIONALLICENCE 773 0- Infection Control & Hospital Epidemiology Cambridge University Press 19/7(1998-07), 494-499 0899-823X 19:7<494 1998 19 ICE CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge