Author: Health Surveillance, Vermont Department of Health

Last Updated: February 2019

In January 2017, the baseline used to calculate the Standardized Infection Ratio (SIR) for C. difficile was updated. This serves as the latest “reference point” for comparing progress. For this reason, there is no benchmark to compare our progress before this point.

In 2015, C. difficile reporting became required for most Vermont hospitals, allowing the Health Department to track Vermont’s progress. In 2017, the Health Department began publishing C. difficile data annually.

Antibiotics can be lifesaving when taken appropriately. Antibiotics kill harmful bacteria to protect against infections, but also destroy the good bacteria living in your body. It takes several months for the good bacteria to recover after being exposed to antibiotics. During this time, harmful bacteria, like C. difficile, can take over and make patients sick. C. difficile causes serious diarrheal illness and can be picked up from contaminated surfaces or spread from a health care provider’s hands. Older adults who take antibiotics and get medical care are at the highest risk.

This indicator is part of Healthy Vermonters 2020 (the State Health Assessment) that documents the health status of Vermonters at the start of the decade and the population health indicators and goals that will guide the work of public health through 2020. Click here for more information.

• Hospitals

• Long-Term Care Facilities
• Healthcare Providers
• New England Association for Practitioners in Infection Control (APIC)
• New England Quality Improvement Network-Quality Improvement Organization (QIN-QIO)
• Centers for Disease Control and Prevention (CDC)
• WHO Collaborating Centre for Surveillance of Antimicrobial Resistance (WHONET)

Vermont follows nationally determined evidence-based programs. Patient lives can be saved when health care providers follow CDC’s 6 Steps to Prevention, which include aggressive cleaning and infection control protocols, along with smart antibiotic prescribing recommendations. The Health Department works with Vermont’s hospitals and long-term care facilities to implement comprehensive prevention programs.

For more information on antibiotic stewardship:

https://www.cdc.gov/antibiotic-use/core-elements/index.html

For more information on C. difficile: https://www.cdc.gov/vitalsigns/HAI/StoppingCdifficile/index.html

The Health Department sponsors the statewide Collaborative to Prevent Healthcare-associated Infections and Antimicrobial Resistance (C-PHAR) in which acute and long-term care facilities work together to prevent infections like C. difficile.

• The Health Department conducts Infection Control Assessment and Response (ICAR) visits to healthcare facilities to help assess infection prevention practices and guide quality improvement activities.
• The Health Department contracts with the University of Vermont Infectious Disease Program to help Vermont hospitals establish and maintain antibiotic stewardship programs.

This work is funded by both a federal grant from CDC and state dollars.

For more information:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763211/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763211/

https://www.cdc.gov/hai/organisms/cdiff/cdiff_infect.html

https://www.cdc.gov/drugresistance/biggest_threats.html

http://www.npr.org/sections/health-shots/2017/06/29/534870581/c-diff-infections-are-falling-thanks-to-better-cleaning-and-fewer-antibiotics