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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 ,
Jianfang Liu ,
Adam Ross Cohen  and
Elaine Larson
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).
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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
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 5 , May 2018 , pp. 541 - 546
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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