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What’s New in the
Patient Safety World
April 2024
Hospital Beds and
C. diff Infection
It sounds rather obvious – you have a higher risk of developing a hospital-onset C diff infection
(HO-CDI) if you are in a hospital bed or room previously occupied by someone with
a Clostridioides difficile infection (CDI). A recent
study confirmed exactly that.
Witt and colleagues (Witt
2023) retrospectively analyzed over 25,000
hospital visits in 2 academic medical centers and found 237 instances of hospital-onset C diff infection
(HO-CDI). There was an association between exposure to a contaminated bed and
the development of HO-CDI in both unadjusted (odds ratio 1.8) and adjusted
analyses (OR 1.5).
Sensitivity analyses
showed this association persisted even after varying the amount of time the
researchers assumed the bed would remain contaminated following the prior
occupant’s C. diff diagnosis. The researchers surmise this is in part
explained by the fact that most patients in a contaminated bed were also
exposed to a contaminated room. They conclude that their findings suggest that there may be transmission of C. diff from the
hospital bed to a patient, even up to 90 days after the original patient was
diagnosed with C. diff.
They suggest that further
studies involving genomic sequencing could more directly link possible bed
contamination and developing HO-CDI and that human-factor analyses could
elaborate on the interactions that healthcare personnel have with the hospital
room, bed, and other surfaces to determine which parts of the healthcare
environment contribute the most to transmission of HO-CDI. They stress the
importance new technologies or cleaning and disinfection methods that can
better eradicate C. difficile spores from a hospital bed and/or the surrounding
healthcare environment might have on reductions in healthcare transmission of
C. diff and decrease rates of HO-CDI.
Some of our prior
columns on C. diff infections:
- November 14, 2017 “Tracking
C. diff to a CT Scanner”
- November 2016 “C. Diff and Your
Predecessor’s Room”
·
August 2021 “Updated
Guidelines on C. diff”
·
October 2021 “HAI’s Increase During
COVID-19 Pandemic”
·
March 2022 “Predicting C. diff Infection
in Just 6 Hours?”
References:
Witt LS, Howard-Anderson J,
Prakash-Asrani R, Overton E, Jacob JT. The role of the hospital bed in
hospital-onset Clostridioides difficile: A
retrospective study with mediation analysis. Infection Control &
Hospital Epidemiology 2023; Published December 13, 2023
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