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54 INFECTION PREVENTION & ANTIBIOTIC RESISTANCE 2 New Jersey Hospitals Unite Against C. diff By Brian Zimmerman T he Valley Hospital in Ridgewood, N.J., and Holy Name Medical Center in Teaneck, N.J., are uniting in the fight against drug-resistant healthcare-acquired Clostridium difficile infections. "C. difficile is public enemy No. 1 and it is clear that defeating it will take a cooperative, multi-institutional and multidisciplinary approach...no one is going to get anywhere without working together," said Neil Gaffin, MD, an infectious disease specialist at e Valley Hospital. C. diff was responsible for 29,000 deaths in 2011, according to the CDC. While 65.8 percent of C. diff cases are healthcare-asso- ciated, only 24.2 percent happened during hospitalization. e rest originate in nursing homes or during outpatient care at another healthcare facility, according to the two hospitals. is suggests the infection is being transferred through a network of nursing homes and outpatient care facilities. Poor coordination and collaboration can put patients at risk. e CDC has called upon healthcare facilities to come together in the fight against the antibiotic-resistant C. diff. In accordance with the CDC's recommenda- tions, representatives from both institutions meet regularly to share best practices regard- ing C. diff prevention and treatment. "We are employing bleach-based disinfec- tants, which are the only compounds that will inactivate the spores, and are restricting the use, spectrum and duration of antibiotic therapy to preserve the normal organisms in a patient," said omas Birch, MD, an infectious disease specialist at Holy Name Medical Center. In addition to working closely with one another, both hospitals are also reaching out to area nursing homes in hopes of limiting the spread of the infection throughout the healthcare cycle. n 10 States Making the Most Progress in the Fight Against HAIs By Shannon Barnet T he CDC published its annual National and State Healthcare-As- sociated Infections Progress Report, which shows hospi- tals across the national are getting better at fighting HAIs. The improvement in 10 states in particular stand out. The 2016 report includes national and state-by-state summaries of six HAI types, based on data reported to the CDC's National Health- care Safety Network in 2014. The HAIs analyzed are central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections, Clostridium diffi- cile infections and methicil- lin-resistant Staphylococcus aureus. Progress on HAI preven- tion is measured using the standardized infection ratio. The following 10 states performed better than the national SIR on at least three infection types. 1. Alabama 2. Colorado 3. Florida 4. Hawaii 5. Idaho 6. Illinois 7. North Carolina 8. Ohio 9. Texas 10. Wisconsin n UTI Intervention Remains Successful for 8 Years, Study Finds By Shannon Barnet U rinary tract infections are the most common type of healthcare-associated infection in the U.S. For hospitals looking to combat UTIs, a study published in March in the American Journal of Infection Control highlights an interven- tion that was successful for nearly a decade. The authors of the study evaluated prospective UTI surveillance from November 2009 to January 2010, and compared the results against a two-year sustainability assessment performed in 2004. All total, 336 consecutive patients were included in the study. A urinary catheter was placed in 17.6 percent of patients, compared to 20 percent in 2004. The UTI incidence rate fell from 2.6 per 1,000 patient days in 2004 to 2.4 per 1,000 patient days in 2010. "The intervention effect was sustained with regard to overall UTI rate and [urinary catheter] placement in the [operating room], but less in the [postanesthesia care unit] and [surgical wards," the study concluded. n "C. difficile is public enemy No. 1." — Neil Gaffin, MD, infectious disease specialist