Clostridioides difficile infection (CDI) in a previous room occupant predicts CDI in subsequent room occupants across different hospital settings

Geeta Sood; Shaun Truelove; Geoff Dougherty; B Mark Landrum; Sonia Qasba; Mayank Patel; Amanda Miller; Christina Wilson; John Martin; Cindy Sears; Alyson Schuster; Mark Sulkowski; Richard Bennett; Noya Galai

doi:10.1016/j.ajic.2022.02.006

Clostridioides difficile infection (CDI) in a previous room occupant predicts CDI in subsequent room occupants across different hospital settings

Am J Infect Control. 2022 Dec;50(12):1352-1354. doi: 10.1016/j.ajic.2022.02.006. Epub 2022 Feb 23.

Authors

Geeta Sood¹, Shaun Truelove², Geoff Dougherty³, B Mark Landrum⁴, Sonia Qasba⁵, Mayank Patel⁶, Amanda Miller⁷, Christina Wilson⁸, John Martin⁸, Cindy Sears⁹, Alyson Schuster¹⁰, Mark Sulkowski⁹, Richard Bennett⁹, Noya Galai¹¹

Affiliations

¹ Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. Electronic address: gsood1@jhmi.edu.
² Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁴ Howard County General Hospital, Columbia, MD, USA.
⁵ Suburban Hospital, Bethesda, MD, USA.
⁶ Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
⁷ Johns Hopkins Health System, Baltimore, MD, USA.
⁸ Premier Inc, Charlotte, NC, USA.
⁹ Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
¹⁰ Health Services Cost Review Commission, MD, USA.
¹¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Statistics, University of Haifa, Mt Carmel, Israel.

PMID: 35217092
DOI: 10.1016/j.ajic.2022.02.006

Abstract

Background: Previous single-center studies suggest that exposure to a room previously occupied by a patient with CDI may increase the risk of CDI in subsequent patients. We evaluated the risk of previous room occupant on CDI risk across 5 adult hospitals.

Methods: This is a non-concurrent cohort study of adult inpatients admitted to 5 hospitals. Exposed rooms were identified as being occupied by a patient diagnosed with CDI and a logistic regression was performed to assess if staying in an exposed room increases the risk of CDI in subsequent patients.

Results: Patients admitted to a room that was previously occupied by a patient with CDI had a 27% increased odds of subsequently being diagnosed with CDI (odds ratio (OR)=1.269; 95% confidence interval (CI)= 1.12-1.44) if exposed within the last 90 days and 40% increased odds (OR=1.401; 95% CI= 1.25-1.57) if exposed in the last 365 days after controlling for previous admissions and length of stay. Cumulative patient-day exposure to previously CDI-positive occupied rooms within both 90 and 365 days were also found to be independently significant, with a 4.5% (OR 1.045; 95% CI = 1.03-1.06) and 4.2% (OR 1.042; 95% CI = 1.03-1.06) increase in odds of CDI with each day of exposure respectively.

Discussion/conclusions: This study adds further evidence that hospital environment in patient rooms may contribute to risk for CDI.

Keywords: Clostridioides Difficile; Hospital Environment; Previous Room Occupant.

MeSH terms

Adult
Clostridioides difficile*
Clostridium Infections* / epidemiology
Cohort Studies
Cross Infection* / epidemiology
Hospitals
Humans
Retrospective Studies
Risk Factors