3.. 2.. 1.. Zero. Great, the 48 hours are up!

Slide1We often see those tasked with finding suitable isolation facilities counting down to when precaustions can be discontinued and the ’48 hours clear’ of symptoms of loose stools or vomiting has almost become one of the most welcome statements heard in healthcare settings. No more contact precautions, no more disinfectants sloshing around, normality beckons.. Or should it?

A new paper from Curtis Donskey’s group in the US studied the level of hand contamination with C. difficile after the magic 48 hour period was up and hand contamination occurred as frequently during the care of patients with recently resolved CDI (12%) as during the care of CDI patients (21%, despite the 100% use of gloves) P= 0.20. Interstingly the frequency of acquisition of spores on hands was similar for nurses, doctors and allied health porfessionals with a moderate positive correlation between time spent with a patient and acquisition. The 21% acquisition from contact with cases within the active period despite the use of gloves is interesting and reinforces my view that we are not there with the safe use of PPE just yet, despite the boost that Ebola training may have provided.

In the words of the song on Contact Precautions from David Soul ‘Don’t give up on us baby”

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2 thoughts on “3.. 2.. 1.. Zero. Great, the 48 hours are up!

  1. Thanks Martin – great post.

    A question – is it important that the rate of contamination in those who were symptomatic was almost double those who were not? I appreciate that this is not a statistically significant difference, but I wonder – is this a failure of sample size to detect a clinically meaningful difference?

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  2. Yes, that’s probably true Jon. It is important that we try and get an understanding of when transmission actually occurs based on a contamination rate I think. Mind you I think that we don’t currently have adequate isolation facilities, so for me the important thing is for staff to realise that no symptoms does not equal no transmission risk

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