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Association Between Hospital-Onset Clostridium difficile infection and Admission to a Multi-Bed Room: A Case–control Study

BACKGROUND: Few studies have directly examined the link between assignment to a multi-bed vs. single-bed room and the risk for hospital onset C. difficileinfection (HO-CDI). Therefore, in this case–control study, we investigated whether assignment to a single-bed room reduced the risk of HO-CDI in a...

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Autores principales: Vaisman, Alon, Jula, Michael, Wagner, Jessica, Winston, Lisa G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631532/
http://dx.doi.org/10.1093/ofid/ofx163.1000
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author Vaisman, Alon
Jula, Michael
Wagner, Jessica
Winston, Lisa G
author_facet Vaisman, Alon
Jula, Michael
Wagner, Jessica
Winston, Lisa G
author_sort Vaisman, Alon
collection PubMed
description BACKGROUND: Few studies have directly examined the link between assignment to a multi-bed vs. single-bed room and the risk for hospital onset C. difficileinfection (HO-CDI). Therefore, in this case–control study, we investigated whether assignment to a single-bed room reduced the risk of HO-CDI in adult inpatients on medical/surgical floors. METHODS: Consecutive cases of HO-CDI, defined as adult patients admitted to San Francisco General Hospital with a new positive C. difficile stool test >72 hours after admission, were identified for the period between January 1, 2010 to December 31, 2015. Patients who first tested positive for C. difficilein the ICU or who had a history of CDI within the last 12 months were excluded. Controls were selected from the general medical/surgical inpatient population using incidence density sampling and matched to cases on the basis of admission unit and length of admission. A multi-bed room was defined as any room with one or more roommates. A multivariate cox proportional hazard model was used to estimate the relationship between room assignment (single vs. multi-bed) and development of HO-CDI. Variables included in the model, on the basis of a directed acyclic graph, were length of admission, HIV infection, and age. RESULTS: 184 cases and 373 controls were identified during the study period. The median ages of cases and controls were 60 years and 56 years, and mean Charlson comorbidity scores were 3.8 and 3.7, respectively. The hazard ratio for the development HO-CDI associated with multi-bed room exposure was 2.32 (P = 0.03) with a 95% CI for the hazard ratio of 1.05 to 5.17. CONCLUSION: In this study, assignment of patients to multi-bed rooms on general medical and surgical wards was associated with an increased hazard for the development of HO-CDI. This finding, especially if confirmed in other institutions, could have implications for patient room assignment and hospital design. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-56315322017-11-07 Association Between Hospital-Onset Clostridium difficile infection and Admission to a Multi-Bed Room: A Case–control Study Vaisman, Alon Jula, Michael Wagner, Jessica Winston, Lisa G Open Forum Infect Dis Abstracts BACKGROUND: Few studies have directly examined the link between assignment to a multi-bed vs. single-bed room and the risk for hospital onset C. difficileinfection (HO-CDI). Therefore, in this case–control study, we investigated whether assignment to a single-bed room reduced the risk of HO-CDI in adult inpatients on medical/surgical floors. METHODS: Consecutive cases of HO-CDI, defined as adult patients admitted to San Francisco General Hospital with a new positive C. difficile stool test >72 hours after admission, were identified for the period between January 1, 2010 to December 31, 2015. Patients who first tested positive for C. difficilein the ICU or who had a history of CDI within the last 12 months were excluded. Controls were selected from the general medical/surgical inpatient population using incidence density sampling and matched to cases on the basis of admission unit and length of admission. A multi-bed room was defined as any room with one or more roommates. A multivariate cox proportional hazard model was used to estimate the relationship between room assignment (single vs. multi-bed) and development of HO-CDI. Variables included in the model, on the basis of a directed acyclic graph, were length of admission, HIV infection, and age. RESULTS: 184 cases and 373 controls were identified during the study period. The median ages of cases and controls were 60 years and 56 years, and mean Charlson comorbidity scores were 3.8 and 3.7, respectively. The hazard ratio for the development HO-CDI associated with multi-bed room exposure was 2.32 (P = 0.03) with a 95% CI for the hazard ratio of 1.05 to 5.17. CONCLUSION: In this study, assignment of patients to multi-bed rooms on general medical and surgical wards was associated with an increased hazard for the development of HO-CDI. This finding, especially if confirmed in other institutions, could have implications for patient room assignment and hospital design. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2017-10-04 /pmc/articles/PMC5631532/ http://dx.doi.org/10.1093/ofid/ofx163.1000 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Vaisman, Alon
Jula, Michael
Wagner, Jessica
Winston, Lisa G
Association Between Hospital-Onset Clostridium difficile infection and Admission to a Multi-Bed Room: A Case–control Study
title Association Between Hospital-Onset Clostridium difficile infection and Admission to a Multi-Bed Room: A Case–control Study
title_full Association Between Hospital-Onset Clostridium difficile infection and Admission to a Multi-Bed Room: A Case–control Study
title_fullStr Association Between Hospital-Onset Clostridium difficile infection and Admission to a Multi-Bed Room: A Case–control Study
title_full_unstemmed Association Between Hospital-Onset Clostridium difficile infection and Admission to a Multi-Bed Room: A Case–control Study
title_short Association Between Hospital-Onset Clostridium difficile infection and Admission to a Multi-Bed Room: A Case–control Study
title_sort association between hospital-onset clostridium difficile infection and admission to a multi-bed room: a case–control study
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631532/
http://dx.doi.org/10.1093/ofid/ofx163.1000
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