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A study of more than 25,000 hospitals encounters found that staying in a hospital bed that previously had a patient with Clostridioides difficile infection (CDI) was associated with an increased risk of hospital-onset (HO)-CDI, researchers reported today in Infection Control & Hospital Epidemiology.
In the study, researchers from Emory University School of Medicine used a real-time location system to track the movement of hospital beds at two academic medical centers from April 2018 to August 2019. They defined patients as being exposed to a potentially contaminated bed if, within the 7 days preceding their HO-CDI diagnosis, they had stayed in a bed that held an occupant with CDI in the previous 90 days. They used multivariable logistics regression to determine whether staying in a contaminated bed was associated with HO-CDI after controlling for time at risk and intensive care unit (ICU) admission.
Strong association with contaminated beds, rooms
Among 25,032 hospital encounters with 18,860 unique patients (51.7% female, 52.9% Black, median age 61 years), the researchers identified 237 cases of HO-CDI. Exposure to a contaminated bed was associated with HO-CDI in unadjusted analyses (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.4 to 2.31) and adjusted analyses (OR, 1.5; 95% CI, 1.2 to 2.0). Even after varying the length of time the researchers assumed the bed would remain contaminated (from 90 days to 60, 30, 14, or 7 days), the association persisted.
The analysis also found that exposure to a contaminated hospital room was associated with HO-CDI in both unadjusted (OR, 1.9; 95% CI, 1.5 to 2.5) and adjusted (OR, 1.5; 95% CI, 1.1 to 1.9) analyses, and that 62% of the relationship between HO-CDI and exposure to a contaminated bed was due to both direct and indirect interaction with a contaminated hospital room.
"New technologies or cleaning and disinfection methods that can better eradicate C. difficile spores from a hospital bed and/or the surrounding healthcare environment may lead to significant reductions in healthcare transmission of C. difficile and decrease rates of HO-CDI," the study authors concluded.