caa a22 4500 606156011 CHVBK 20210128100606.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s10096-015-2362-5 doi (NATIONALLICENCE)springer-10.1007/s10096-015-2362-5 Containment of Clostridium difficile infection without reduction in antimicrobial use in Hong Kong [Elektronische Daten] [V. Cheng, P. Chau, S. So, J. Chen, R. Poon, S. Wong, I. Hung, W. Lee, J. Tai, P. Ho, W. Yam, K. Yuen] Clostridium difficile ribotype 002 with hypersporulating capacity has been increasingly identified in Hong Kong. Proactive infection control measures are important to prevent the establishment of endemicity of C. difficile ribotype 002. A total of 329 patients with healthcare-associated C. difficile infection (CDI) were recruited in our healthcare network between 1 January 2008 and 30 June 2012 in this study. The incidence rates of healthcare-associated CDI per 10,000 admissions and 10,000 patient-days increased significantly by 15.3 and 17.0%, respectively, per quarter (p < 0.001) from 2008 1Q to 2010 1Q by segmented Poisson regression. With the full implementation of enhanced infection control interventions, there was an immediate significant reduction in both healthcare-associated CDI rates per 10,000 admissions and per 10,000 patient-days by 47% (p < 0.001) in 2010 2Q, followed by a further decline of CDI per 10,000 admissions and CDI per 10,000 patient-days by −19.4 and −19.8% from 2010 2Q to 2012 2Q, respectively (p < 0.001), despite a replacement of hand washing with soap and water by alcohol-based hand rub in the healthcare network. The proportion of C. difficile ribotype 002 was not statistically different (34/177, 19.2% vs. 25/152, 16.4%, p = 0.515), and the consumption of broad-spectrum antibiotics presented as divided daily dose per 1,000 acute bed-day occupancy per quarter remained unchanged (140.9 vs. 152.3) before and after infection control interventions. Our results suggested that the reduction of healthcare-associated CDI was attributable to infection control interventions instead of replacement of ribotypes or reduction in antimicrobial selective pressure. Springer-Verlag Berlin Heidelberg, 2015 Cheng V. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Chau P. School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, China aut So S. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Chen J. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Poon R. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Wong S. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Hung I. Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Lee W. Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Tai J. Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Ho P. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Yam W. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut Yuen K. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/7(2015-07-01), 1381-1386 0934-9723 34:7<1381 2015 34 10096 https://doi.org/10.1007/s10096-015-2362-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2362-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cheng V. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Chau P. School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- So S. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Chen J. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Poon R. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Wong S. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Hung I. Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Lee W. Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Tai J. Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Ho P. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Yam W. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 700 1- Yuen K. Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/7(2015-07-01), 1381-1386 0934-9723 34:7<1381 2015 34 10096