A set of training materials for professionals working in intervention epidemiology, public health microbiology and infection control and hospital hygiene.
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1. Clostridium difficile transmission.
The two major reservoirs of C. difficile in healthcare settings are infected patients and, since C. difficile can survive in the hospital environment, inanimate objects. C. difficile can be spread by direct and indirect contact with the patient or the patient’s environment.
2. Isolation of patients with CDI.
Guideline recommends to place patient with CD on appropriate contact precautions (CP) and to assign him to a private room with a bathroom that is only for use by that patient (isolation) .
Early identification of patients with CDI is the first step in preventing the spread of the disease. For this reason pre-emptive isolation and CP are recommended for all patients with diarrhea, especially if healthcare-associated.
When a private room is not available, the best patient placement options should be determined. A possibility is to place patients with CDI in a cohort where CP must always be applied. In the cohort other actions may be considered, including the use of spatial separation to reduce the possibility of sharing of items.
Isolation of patients with CDI may be discontinued for two days after diarrhea stops. A patient who is cohorted for CDI should be moved to a clean room once diarrhea resolves to prevent re-infection.
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Marion Muehlen posted on 2/24/2015 10:58:24 AM:
Thank you, Arnold, very helpful information.
chwilliams replied on 10/2/2015 8:42:54 AM: The outbreak team is a group of people with appropriate skills and responsibilities joined by the aim of investigating and controlling the outbreak. It is usually multidisciplinary , including ( non-exhaustive list) epidemiologists, microbiologists, public health authorities, clinicians and healthcare managers, environmental and food inspectors, veterinarians, communications specialists.
An OCT should act as as single body and behave as a effective team. There should be a lead to chair the meeting and ensure decisions are taken , documented and acted upon. The OCT has collective responsibility for the outbreak - if it goes wrong, responsibility is shared. The outputs, especially public health advice and external communications , should be consistent from each member and agency, although there may be disagreements during meetings.
Other models can be useful. In at least one country, a team similar to an OCT meets every week to manage incidents and outbreaks, making more routine the often hasty convening of s meeting of senior professionals.
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