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February 13, 2006

Universal Patient Disinfection as a Tool for Infection Control: Rub-A-Dub-Dub, No Need for a Tub

Arch Intern Med. 2006;166(3):274-276. doi:10.1001/archinte.166.3.274

The management of emerging and reemerging infections in today's health care practice is daunting, to say the least. We are all aware of the seemingly constant recognition of new diseases, such as severe acute respiratory syndrome–associated coronavirus1 and avian influenza,2 as well as the introduction of new faces on old pathogens, exemplified by multidrug-resistant Acinetobacter baumanii3 and Pseudomonas aeruginosa4 and community-associated methicillin-resistant Staphylococcus aureus (MRSA).5 The spread of these and other infectious diseases is the result of 3 interrelated factors: the relationship(s) between microorganisms, their hosts, and the environment.6 Critical tools for management of health care–associated infections are comprehensive infection-control practices that are often insufficiently followed.7 In this issue of the ARCHIVES, Vernon and colleagues8 evaluate a novel intervention with the focus on interrupting the host as a reservoir for contamination of the environment and health care workers to halt the spread of multidrug-resistant microorganisms. These investigators, working in a large metropolitan Chicago hospital, ask, Does lowering the microbial density of health care–associated pathogens for all patients in intensive care units decrease the contamination of the environment and health care workers' hands and thus result in less microbial spread to other patients in the unit? They addressed the question by using vancomycin-resistant enterococci (VRE) as the microbial target because of its propensity for skin and environmental contamination9,10 and used chlorhexidine gluconate as the skin disinfectant because it is effective and has little potential for toxic effects.

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