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Previous hospital bed occupants pose serious HAI risk to future patients

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April 3, 2018

Hospital patients with health care-associated infections were nearly six times more likely than uninfected patients to have been exposed to a bed whose previous occupant had the same infectious organism, researchers reported.

Infected patients were also nearly five times as likely as those who were uninfected to have been exposed to a roommate with the same organism. The findings suggest that more vigilant cleaning efforts are needed to prevent health care-associated infections (HAIs), they wrote in Infection Control & Hospital Epidemiology.

“As the largest study to quantify the association between HAIs and exposure to infected or colonized previous bed occupants and roommates, encompassing data from all inpatients units in four acute-care hospitals and surveying exposure to six different organisms, our analysis serves to illustrate how many infections might be prevented by implementing enhanced cleaning measures,” researcher Bevin Cohen, MS, MPH, PhD, an associate research scientist at the Columbia University School of Nursing, and colleagues wrote.

The researchers conducted a retrospective analysis of data from patients treated at a community hospital, pediatric acute-care hospital, adult tertiary/quaternary-care hospital and pediatric/adult tertiary/quaternary-care hospital, all in New York City and all in the same health care network. The patients were discharged between Jan. 1, 2006, and Dec. 31, 2012.

The study included a total of 10,289 HAI cases with any of six organisms — Staphylococcus aureus, oxacillin-resistant S. aureus, ampicillin-sulbactam-sensitive and resistant Acinetobacter baumannii, penicillin-sensitive and resistant Streptococcus pneumoniae, levofloxacin-sensitive and resistant Pseudomonas aeruginosa, imipenem-sensitive and resistant Klebsiella pneumoniae, vancomycin-sensitive and resistant Enterococcus faecalis and vancomycin-sensitive and resistant Enterococcus faecium. Cases were matched in a 1:1 ratio with control patients who had none of those HAIs during hospitalization.

The researchers found that case patients were 5.83 times more likely than controls to have been exposed to a bed previously occupied by someone with the same infectious organism (95% CI, 3.62-9.39). Similarly, case patients were 4.82 times more likely to have been exposed to a roommate with the same organism (95% CI, 3.67-6.34).

Citing previous studies, Cohen and colleagues said their findings add to evidence that health care providers must be proactive in decontaminating hospital rooms, especially in light of growing antimicrobial resistance.

The human and financial costs associated with HAIs are unacceptably high and may continue to grow along with antimicrobial resistance and the shortage of novel therapies on the immediate horizon,” they wrote. “In light of mounting evidence that patients harboring pathogens do contaminate their hospital rooms, that current standards for cleaning and disinfection are not sufficient for decontamination and that exposure to contaminated rooms confers a five- to sixfold increase in odds of infection, hospitals must take action by adopting proven methods for reducing environmental contamination.” – by Joe Green

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Disclosures: The authors report no relevant financial disclosures.

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