Protective barrier containment to prevent C. difficile in endoscopy rooms: A prospective, hospital-based intervention study

OBJECTIVES: To investigate the contamination of high-touch surfaces by Clostridioides difficile (C. difficile) in endoscopy rooms and evaluate the impact of a targeted intervention. METHODS: A prospective study was conducted in the endoscopy rooms across three tertiary hospitals in China, focusing on four high-touch surfaces: transfer beds, treatment carts, endoscope hosts, and computer peripherals. C. difficile was detected using real-time PCR. The intervention was designed to prevent C. difficile infection (CDI) via the high-touch surfaces in endoscopy rooms. CDI incidence and associated medical costs were collected for analysis. RESULTS: The overall contamination rate of C. difficile was 6.5% (20/308). Transfer beds had the highest contamination rate at 17.2% (20/116), associated with incomplete sheet coverage. Based on these findings, a single-use of full-bed protective barrier containment (PBC) was implemented in one endoscopic center for all patients. Following this intervention one year, transfer bed contamination fell to 0% (P = 0.043). Importantly, the CDI incidence rate in the investigated hospital decreased significantly from 0.15 to 0.10 cases per 1000 patient-days (P = 0.009). Assuming nationwide use, PBC could save 5.74 billion CNY (0.81 billion USD) per one year based on 2024 data. CONCLUSION: Single-use of full-bed PBC significantly reduced C. difficile contamination and CDI incidence, potentially offering a practical and cost-effective infection control solution for endoscopy settings.