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ICAAC: Daily Bleach Washdown Wipes Out VRE Bacteremia

An Australian hospital that instituted aggressive infection control measures including daily facility-wide washdowns with high-strength bleach completely eliminated bloodstream infections with vancomycin-resistant enterococci (VRE) in high-risk wards, researchers reported here.

Following implementation of the new protocols, the rate of VRE bacteremia in the intensive care unit, transplant units, and other wards at high risk for such infections fell to zero, compared with 0.48 per 100 patients with blood cultures before the intervention (P=0.0004), according to Andrew Mahony, MD, of Austin Health in Melbourne.

Rates of VRE colonization in new patients were also reduced significantly, he said in a platform presentation here at the Interscience Conference on Antimicrobial Agents and Chemotherapy.

Besides the daily bleach cleaning, the new protocol also included sleeveless plastic aprons for patient care workers in place of the standard gowns, and eliminating a requirement that workers wear gloves at all times.

Mahony said the Austin Health hospital had followed CDC infection control guidelines since 1994, yet was experiencing a dramatic increase in VRE colonization rates.

In 1994, he said, the hospital identified one patient with a positive rectal swab for VRE. In 2009, the number had risen to 597.

The CDC guidelines call for single rooms for VRE-positive patients; requiring that staff serving these areas wear gloves and gowns at all times; bleach cleaning of "VRE rooms" after patient discharge; and regular hand washing for all staff.

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