An outbreak of Clostridium difficile-associated disease (CDAD) in a German university hospital

Excerpt

We investigated an outbreak of Clostridium difficile (CD)-associated disease (CDAD) in a cardiac surgical department that took place between January 25th and April 28th 2007 at Hannover Medical School, Germany. Immediate infection control measures such as changing the surface disinfectant from an alcohol-based glucoprotamine to an oxygen-active disinfectant cleaner and the primary education of staff were proved to be insufficient to control the outbreak. Therefore, a “CD infection control bundle” was created consisting of: (a) implementation of a CDAD outbreak team; (b) education on hand hygiene; (c) the aim of early case finding as soon as clinical symptoms of CDAD were noticed; (d) daily control of microbiological results; (e) suggesting proper antimicrobial therapy of patients on the ward avoiding high-risk substances; (f) reinforcement of currently existing infection control measures, such as including the isolation of CDAD cases in single rooms; (g) and, finally, interim closure of the unit for any new admissions. For the treatment of CDAD, initially, metronidazole and, in the case of failure of initial therapy, oral vancomycin were used. …