%0 Journal Article %1 kaier_two_2009 %A Kaier, Klaus %A Hagist, Christian %A Frank, Uwe %A Conrad, Andreas %A Meyer, Elisabeth %D 2009 %J Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America %K Academic Agents, Alcohols, Analysis, Centers, Clostridium Cross Disinfectants, Enterocolitis, Factors Germany, Handwashing, Humans, Incidence, Infection, Infections, Length Medical Multivariate Pseudomembranous, Staphylococcal Staphylococcus Stay, Time aureus, difficile, of {Anti-Bacterial} {Methicillin-Resistant} %N 4 %P 346--353 %R 10.1086/596605 %T Two time-series analyses of the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus infection and Clostridium difficile infection %U http://www.ncbi.nlm.nih.gov/pubmed/19236282 %V 30 %X OBJECTIVE: To determine the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection and Clostridium difficile infection (CDI). METHODS: Two multivariate time-series analyses were performed that used as dependent variables the monthly incidences of nosocomial MRSA infection and CDI at the Freiburg University Medical Center during the period January 2003 through October 2007. The volume of alcohol-based hand rub solution used per month was quantified in liters per 1,000 patient-days. Antibiotic consumption was calculated in terms of the number of defined daily doses per 1,000 patient-days per month. RESULTS: The use of alcohol-based hand rub was found to have a significant impact on the incidence of nosocomial MRSA infection (P\textless .001). The multivariate analysis (R2=0.66) showed that a higher volume of use of alcohol-based hand rub was associated with a lower incidence of nosocomial MRSA infection. Conversely, a higher level of consumption of selected antimicrobial agents was associated with a higher incidence of nosocomial MRSA infection. This analysis showed this relationship was the same for the use of second-generation cephalosporins (P= .023), third-generation cephalosporins (P= .05), fluoroquinolones (P= .01), and lincosamides (P= .05). The multivariate analysis (R2=0.55) showed that a higher level of consumption of third-generation cephalosporins (P= .008), fluoroquinolones (P= .084), and/or macrolides (P= .007) was associated with a higher incidence of CDI. A correlation with use of alcohol-based hand rub was not detected. CONCLUSION: In 2 multivariate time-series analyses, we were able to show the impact of hand hygiene and antibiotic use on the incidence of nosocomial MRSA infection, but we found no association between hand hygiene and incidence of CDI.

@article{kaier_two_2009, abstract = {{OBJECTIVE:} To determine the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus {(MRSA)} infection and Clostridium difficile infection {(CDI).} {METHODS:} Two multivariate time-series analyses were performed that used as dependent variables the monthly incidences of nosocomial {MRSA} infection and {CDI} at the Freiburg University Medical Center during the period January 2003 through October 2007. The volume of alcohol-based hand rub solution used per month was quantified in liters per 1,000 patient-days. Antibiotic consumption was calculated in terms of the number of defined daily doses per 1,000 patient-days per month. {RESULTS:} The use of alcohol-based hand rub was found to have a significant impact on the incidence of nosocomial {MRSA} infection {(P{\textless}} .001). The multivariate analysis {(R2=0.66)} showed that a higher volume of use of alcohol-based hand rub was associated with a lower incidence of nosocomial {MRSA} infection. Conversely, a higher level of consumption of selected antimicrobial agents was associated with a higher incidence of nosocomial {MRSA} infection. This analysis showed this relationship was the same for the use of second-generation cephalosporins {(P=} .023), third-generation cephalosporins {(P=} .05), fluoroquinolones {(P=} .01), and lincosamides {(P=} .05). The multivariate analysis {(R2=0.55)} showed that a higher level of consumption of third-generation cephalosporins {(P=} .008), fluoroquinolones {(P=} .084), and/or macrolides {(P=} .007) was associated with a higher incidence of {CDI.} A correlation with use of alcohol-based hand rub was not detected. {CONCLUSION:} In 2 multivariate time-series analyses, we were able to show the impact of hand hygiene and antibiotic use on the incidence of nosocomial {MRSA} infection, but we found no association between hand hygiene and incidence of {CDI.}}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Kaier, Klaus and Hagist, Christian and Frank, Uwe and Conrad, Andreas and Meyer, Elisabeth}, biburl = {https://www.bibsonomy.org/bibtex/2705bcfdd4dea6382a49173859424d99e/jelias}, doi = {10.1086/596605}, interhash = {5f73d12d66a3a28f26fc6ede34d137d6}, intrahash = {705bcfdd4dea6382a49173859424d99e}, issn = {1559-6834}, journal = {Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America}, keywords = {Academic Agents, Alcohols, Analysis, Centers, Clostridium Cross Disinfectants, Enterocolitis, Factors Germany, Handwashing, Humans, Incidence, Infection, Infections, Length Medical Multivariate Pseudomembranous, Staphylococcal Staphylococcus Stay, Time aureus, difficile, of {Anti-Bacterial} {Methicillin-Resistant}}, month = apr, note = {{PMID:} 19236282}, number = 4, pages = {346--353}, timestamp = {2011-03-11T10:06:24.000+0100}, title = {Two time-series analyses of the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus infection and Clostridium difficile infection}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19236282}, volume = 30, year = 2009 }