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Association Between Healthcare-Associated Infection and Exposure to Hospital Roommates and Previous Bed Occupants with the Same Organism

Published online by Cambridge University Press:  28 February 2018

Bevin Cohen*
Affiliation:
School of Nursing, Columbia University, New York, New York Mailman School of Public Health, Columbia University, New York, New York
Jianfang Liu
Affiliation:
School of Nursing, Columbia University, New York, New York
Adam Ross Cohen
Affiliation:
Independent Consultant, Rockville Centre, New York
Elaine Larson
Affiliation:
School of Nursing, Columbia University, New York, New York Mailman School of Public Health, Columbia University, New York, New York
*
Address correspondence to Ms. Bevin Cohen, Columbia University School of Nursing, 630 West 168th Street, New York, NY 10032 (bac2116@columbia.edu).

Abstract

OBJECTIVE

To quantify the association between having a prior bed occupant or roommate with a positive blood, respiratory, urine, or wound culture and subsequent infection with the same organism.

DESIGN

Case-control study.

SETTING

The study included 4 hospitals within an academically affiliated network in New York City, including a community hospital (221 beds), a pediatric acute-care hospital (283 beds), an adult tertiary-/quaternary-care hospital (647 beds), and a pediatric and adult tertiary-/quaternary-care hospital (914 beds).

PATIENTS

All 761,426 inpatients discharged from 2006 to 2012 were eligible. Cases included all patients who developed a healthcare-associated infection (HAI) with Staphylococcus aureus, Acinetobacter baumannii, Streptococcus pneumoniae, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterococcus faecalis, or Enterococcus faecium. Controls were uninfected patients matched by fiscal quarter, hospital, and length of stay. For each bed occupied during the 3–5-day period prior to infection, microbiology results for assigned roommates and the patient who occupied the bed immediately prior to the case were collected. For controls, the day of infection of the matched case served as the reference point.

RESULTS

In total, 10,289 HAIs were identified. In a multivariable analysis controlling for both exposures and patient characteristics, the odds of cases having been exposed to a prior bed occupant with the same organism were 5.83 times that of controls (95% confidence interval [CI], 3.62–9.39), and the odds of cases having been exposed to a roommate with the same organism were 4.82 times that of controls (95% CI, 3.67–6.34).

CONCLUSION

Infected or colonized roommates and prior occupants do pose a risk, which may warrant enhanced terminal and intermittent cleaning measures.

Infect Control Hosp Epidemiol 2018;39:541–546

Type
Original Articles
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

REFERENCES

1. Klevens, RM, Edwards, JR, Richards, CL, et al. Estimating health care-associated infections and deaths in US hospitals, 2002. Public Health Rep 2007;122:160166.CrossRefGoogle Scholar
2. Scott, RD II. The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention. Centers for Disease Control and Prevention website. http://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf. Published 2009. Accessed July 27, 2017.Google Scholar
3. Magill, SS, Edwards, JR, Bamberg, W, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014;370:11981208.CrossRefGoogle ScholarPubMed
4. Umscheid, CA, Mitchell, MD, Doshi, JA, Agarwal, R, Williams, K, Brennan, PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol 2011;32:101114.CrossRefGoogle ScholarPubMed
5. Jeeva, RR, Wright, D. Healthcare-associated infections: a national patient safety problem and the coordinated response. Med Care 2014;52:S4S8.CrossRefGoogle ScholarPubMed
6. Stone, PW, Glied, SA, McNair, PD, et al. CMS changes in reimbursement for HAIs: setting a research agenda. Med Care 2010;48:433439.CrossRefGoogle ScholarPubMed
7. Ranji, SR, Shetty, K, Posley, KA, et al. Closing the quality gap: a critical analysis of quality improvement strategies (vol. 6, Prevention of healthcare–associated infections). Technical Review, No. 9.6. Rockville, MD: Agency for Healthcare Research and Quality (US); 2007.Google Scholar
8. Dancer, SJ. The role of environmental cleaning in the control of hospital-acquired infection. J Hosp Infect 2009;73:378385.CrossRefGoogle ScholarPubMed
9. Boyce, JM. Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals. Antimicrob Resist Infect Control 2016;5:10.CrossRefGoogle ScholarPubMed
10. Apte, M, Neidell, M, Furuya, EY, Caplan, D, Glied, S, Larson, E. Using electronically available inpatient hospital data for research. Clin Transl Sci 2011;4:338345.CrossRefGoogle ScholarPubMed
11. Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309332.CrossRefGoogle ScholarPubMed
12. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. National Academy Press website. http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf. Published 2001. Accessed January 24, 2018.Google Scholar
13. Wang, Y, Eldridge, N, Metersky, ML, et al. National trends in patient safety for four common conditions, 2005–2011. N Engl J Med 2014;370:341351.CrossRefGoogle ScholarPubMed
14. Bassetti, M, Merelli, M, Temperoni, C, Astilean, A. New antibiotics for bad bugs: where are we? Ann Clin Microbiol Antimicrob 2013;12:22.CrossRefGoogle Scholar
15. Anderson, DJ, Chen, LF, Weber, DJ, et al. Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study. Lancet 2017;389:805814.CrossRefGoogle ScholarPubMed
16. Cohen, B, Cohen, CC, Loyland, B, Larson, EL. Transmission of health care-associated infections from roommates and prior room occupants: a systematic review. Clin Epidemiol 2017;9:297310.CrossRefGoogle ScholarPubMed
17. Freedberg, DE, Salmaian, H, Cohen, B, Abrams, JA, Larson, EL. Receipt of antibiotics in hospitalized patients and risk for Clostridium difficile infection in subsequent patients who occupy the same bed. JAMA Intern Med 2016;176:18011808.CrossRefGoogle ScholarPubMed
18. Russotto, V, Cortegiani, A, Raineri, SM, Giarratano, A. Bacterial contamination of inanimate surfaces and equipment in the intensive care unit. J Intensive Care 2015;3:54.CrossRefGoogle ScholarPubMed
19. Siani, H, Maillard, JY. Best practice in healthcare environmental decontamination. Eur J Clin Microbiol Infect Dis 2015;34:111.CrossRefGoogle Scholar
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