Private hospital rooms lower risk of C. difficile

Private hospital rooms lower risk of C. difficile.

BY ANDRE PICARD - PUBLIC HEALTH REPORTER
Article taken from the Globe and Mail - January 6, 2010

The more roommates you have during a hospital stay, the greater your risk of acquiring a dangerous infectious disease such as Clostridium difficile, according to new Canadian research.
The study, published in the American Journal of Infection Control, shows that each roommate a patient is exposed to hikes his or her risk of infection by 10 per cent.
“That is a significant risk,” Dick Zoutman, a professor of community health and epidemiology at Queen’s University in Kingston, Ont., said in an interview. He noted that, in Canada, most hospital rooms have either two or four beds and “there is a lot of turnover,” meaning that patients are routinely and unnecessarily exposed to a lot of infectious diseases.
Dr. Zoutman said that the research provides powerful evidence that single rooms are the safest, and should be the norm. “The take-home message is that our hospitals should be designed with private rooms for everyone,” he said.
While there would be an upfront cost, Dr. Zoutman noted that, over the long term, savings would be substantial: “This research provides the direct proof that should settle the discussion about the need for private rooms.”
Earlier research showed that about 225,000 patients a year suffer from hospital-acquired infections that substantially extend their stays, and between 8,000 and 12,000 people die annually as a result.

Shared washrooms may be the culprit

The new study was conducted at Kingston General Hospital, which was has 451 in-patient beds and about 17,000 patients a year. There are 107 single-occupancy rooms, 83 double-occupancy, six triple-occupancy, plus open bay areas and specialized units such as intensive care.
The study, which began as a master’s thesis by Queen’s student Meghan Hamel, examined patient records from 2001 to 2006. The research team looked for patients who suffered from three common but dangerous infections – C. difficile, methicillin-resistance Staphylococcus aureus (MSRA) and vancomycin-resistant Enterococcus (VRE) – and examined those patients’ exposure to other patients.
For each roommate to whom a patient was exposed, the risk of contracting C. difficile increased 11 per cent; for MSRA, 10 percent, for VRE, 15 per cent.
The median number of roommates was just over two, but some patients had as many as 46 roommates, whether due to a lengthy stay or to a heavy rotation of roommates.
Dr. Zoutman, who is also head of infection control at Kingston General, said that although the research was conducted at only one institution, “it is pretty typical of a Canadian hospital, and there is no reason to think this situation doesn’t exist everywhere.”
The infections that were studied- C. difficile, MSRA and VRE- are not airborne, but spread by contact.
Dr. Zoutman said the likely reason that roommates increase the risk of infection is that patients share a washroom. (The mantra in infection control is: One bum per toilet.) Another likely explanation involves inadequate hand washing by patients and health professionals alike; doctors sometimes don’t wash their hands between patient visits in a single room.
“The goal should be private rooms, or at the least, semi-private rooms,” Dr. Zoutman said. “But in the meantime, there are things we can do: We should be cleaning our hands, and we should really scrutinize how we clean our hospitals.”

A lack if roommates can help prevent routine and unnecessary exposure to infectious diseases.