Researchers developed an agent-based model of Clostridium difficile transmission and used it to evaluate the comparative clinical effectiveness of nine single interventions and eight multiple-intervention bundles. They published their findings in Clinical Infectious Diseases.
The researchers developed the agent-based model using studies from the literature, supplemented with primary data collection. The used the model in a 200-bed adult hospital. The model included an environmental component and four agent types: patients, visitors, nurses and physicians.
They used the model to examine the effectiveness of the single interventions and multiple-intervention bundles at reducing hospital-onset C. diff, or HO-CDI, and asymptomatic C. diff colonization.
The study shows the most effective single-intervention strategies were:
• Daily cleaning with sporicidal disinfectant, which reduced HO-CDI by 68.9 percent
• C. diff screening at admission, which reduced 35.7 percent
The researchers combined these two strategies into a two-intervention bundle, which reduced HO-CDI by 82.3 percent and asymptomatic hospital-onset colonization by 90.6 percent. Patient hand hygiene compliance strategies reduced HO-CDI rates an additional 7.9 percent.