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UMMC reports progress on dealing with C. diff outbreak

By Howard B. Owens

UMMC is making progress in dealing with a recent outbreak of Clostridium difficile, according to spokeswoman Colleen Flynn.

The number of patients being screened for potentially having C. diff has dropped from six last weekend to three.

And staff, using a sterilization machine designed to clean potentially contaminated surfaces, has learned how to use the equipment to exceed the manufacturer's standards for cleaning surfaces.

"We would really like the current cases to be the last cases," Flynn said. "We don't want any more hospital-acquired cases. We want to eradicate it all together."

Dealing with C. diff and other infectious bacteria is a concern for all hospitals, but the recent outbreak at UMMC brought the local hospital into the spotlight.

Flynn said staff noticed an uptick in C. diff cases before the news hit local media and began new procedures -- in consultation with the State Health Department -- to deal with the spike.

"We immediately took steps to see what else we could do," Flynn said.

When the weekend rolled around and the number of patients at the hospital (called the "census") dropped, staff was able to move patients out of some rooms and group patients together based on their treatment. The hospital also began extra sterilization procedures where necessary and increased staffing to stop the spread of the bacteria.

"We told the Department of Health what we would like to do and the Department of Health concurred that these were great steps," Flynn said.

From Feb. 28 to April 15, UMMC has reported 11 hospital-acquired cases of C. diff and six community-acquired cases (meaning the patients had C. diff before arriving at UMMC), according to Department of Health officials.

One patient who contracted C. diff died in March, but the cause of death has not been determined. The patient had other serious health issues and the cause of death may not have been due to C. diff.

Currently, there are five patients with C diff at UMMC. Four are being treated and one is in comfort care.

Every patient that displays C. diff symptoms -- particularly, diarrhea -- is tested for the bacteria.

Currently, only three patients are being screened, which Flynn said is a good sign the hospital's procedures are working.

"For what we usually see, this is a positive trend for where we want to be," Flynn said.

Tom Allocco, a spokesman for the Department of Health, said the spike in UMMC's numbers is not so great that it should cause public concern. When the department used the term "outbreak" in a previous statement, it merely signified an increase over previous reports of C. diff.

Flynn said UMMC went six straight months earlier in 2010 without a single case of C. diff and finished off 2010 with five straight months of no C. diff patients.

Flynn said the hospital recently purchased a machine designed to eliminate most C. diff bacteria on hard surfaces.

Staff followed the manufacturer's recommended cleaning solutions and procedures for sterilizing surfaces. Then, when scanned for the presence of live matter on the surfaces, the count came within the expected range.

However, that wasn't good enough for UMMC, Flynn said.

They tried again using extra friction and when they scanned again, there was no live matter at all on the surfaces.

"We learned something," Flynn said. "We learned, OK, use the solution mixture recommended by the manufacturer, but (by applying) more friction, we could bring the count down to zero."

In a follow up e-mail, Flynn provided this statement on UMMC's C. diff procedures.

Clostridium difficile precautions at UMMC:
If a patient is admitted with diarrhea, or develops it, while hospitalized and is being tested for C. diff, the patient is immediately placed on Contact Plus Precautions. This means that the STOP sign is placed under the room number so it can be seen before someone enters, and a Contact Plus Precautions sign is posted on the PPE caddy. It specifies that hands are to be washed with soap and water, to wash any spores that may have gotten on the hands of the person down the drain.

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