Clostridioides difficile Module 2 Evidence-tabel
Evidence table for intervention studies (randomized controlled trials and non-randomized observational studies [cohort studies, case-control studies, case series])
Study reference |
Study characteristics |
Patient characteristics |
Intervention (I) |
Follow-up |
Outcome measures and effect size |
Comments |
---|---|---|---|---|---|---|
Jabbar, 2010 |
Type of study: prospective cohort |
Inclusion criteria: ten healthy volunteers, all of them nonclinical research personnel at Hines VA Hospital |
Describe intervention: hand washing using alcohol-based hand rub compared to Chlorhexidine hand wash |
Length of follow-up: no follow-up |
Outcome measures: |
The authors conclude that hand washing with soap and water is significantly more effective at removing C. difficile spores from the hands of volunteers than are ABHRs. Residual spores are readily transferred by a handshake after use of ABHR. |
Knight, 2010 |
Type of study: retrospective chart review |
Inclusion criteria: adult (age ≥18 years) patients with CDAD and in-patient status at our institution between January 1, 2001, and June 30, 2008 |
Describe intervention: implementation of AHBR (Alcohol based hand rub) policy |
Length of follow-up: 7,5 years |
Outcome measures: |
The authors conclude that the data provides no evidence of an increased CDAD rate after implementation of an ABHR policy at our institution. |
Kundrapu, 2014 |
Type of study: prospective cohort study |
Inclusion criteria: adult (age ≥18 years) patients with CDI (Clostridioides difficile-infectie) or asymptomatic carriers of toxigenic C. difficile identified through rectal surveillance cultures |
Describe intervention: hand hygiene using alcohol hand rub (Purell) or soap and water hand wash with soap containing 0.5% triclosan |
Length of follow-up: not applicable |
Outcome measures: |
The authors conclude that the hand washing was effective for reducing levels of C. difficile spores on hands. |
Oughton, 2010 |
Type of study: prospective randomized cross-over study |
Inclusion criteria: ten hospital laboratory workers volunteered for this study |
Describe intervention: The hand hygiene interventions studied were (1) warm (30 C) water with plain soap (Hygenipak Instafoam, Deb Canada), (2) cold (15 C) water with plain soap (Hygenipak Instafoam, Deb Canada), (3) warm (30 C) water with 2% chlorhexidine antibacterial soap (Hygenipak 2% CHG foaming skin cleanser, Deb Canada), (4) antiseptic hand wipes with 40% vol/vol ethanol and 0.5% parachlorometaxylenol (Sani-dex antimicrobial hand wipes, PDI), (5) alcohol-based handrub with 70% vol/vol isopropanol (Manorapid, Antiseptica, Pulheim-Brauwiler), and (6) a no-wash negative control. |
Length of follow-up: not applicable |
Outcome measures: |
The authors conclude that handwashing with soap and water showed the greatest efficacy in removing C. difficile and should be performed preferentially over the use of alcohol-based handrubs when contact with C. difficile is suspected or likely. |