1706. Transmission of Healthcare-associated Infections from Roommates and Prior Room Occupants:  A Systematic Review
Session: Poster Abstract Session: Infection Prevention: Cleaning and Disinfection
Saturday, October 10, 2015
Room: Poster Hall

Background:   Infected patients can contaminate hospital environments, but risks posed to roommates and subsequent room occupants are not well understood.  This systematic review summarizes literature quantifying transmission risk from infected roommates and prior room occupants to exposed patients.   

Methods:   We searched PubMed using terms piloted with a reference librarian to identify original research articles published in English from 1/1/90 – 12/31/14.  Articles were reviewed independently by three researchers and included if they compared incidence of infection or colonization in patients exposed to infectious roommates or prior room occupants with incidence of infection or colonization in unexposed patients, and were conducted in acute or long-term healthcare settings.

Results:   Nineteen articles met the criteria (Figure).  Studies (Table) varied methodologically (e.g., subject selection, case finding, confounder control) and operationalized exposure and outcome in different ways (e.g., infection vs. colonization, length of exposure).  Most articles reported significant positive associations between exposure to infected roommate (8/13, 66%) or exposure to room with infected prior occupant (5/8, 63%) and infection/colonization with either vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, Group A Streptococcus, influenza, multidrug-resistant Gram negative bacilli (MDR GNB), or Hepatitis C.  Only one study reported a significant negative association.

Conclusion:   This review suggests that patients exposed to roommates or rooms previously occupied by patients with infections from a wide variety of pathogens are at increased risk of infection.  These results support efforts to isolate infected patients in single rooms and enhance terminal cleaning procedures after infected patients are discharged. 

 

Characteristics of Included Articles

N (%)

Setting

 

Acute care

13 (68)

Long-term care

6 (32)

Organism*

 

VRE

6 (32)

MRSA

4 (21)

C. difficile

3 (16)

Group A Streptococcus

3 (16)

Influenza

2 (11)

MDR GNB

2 (11)

Cryptosporidium

1 (5)

Hepatitis C

1 (5)

Pseudomonas cepacia

1 (5)

Exposure*

 

Roommate

13 (68)

Prior room occupant

8 (42)

*Some articles included results for >1 category.

 

Bevin Cohen, MPH, MPhil, Catherine Crawford Cohen, BS, RN, PhD(c) and Borghild Løyland, PhD, RN, Columbia University School of Nursing, New York, NY

Disclosures:

B. Cohen, None

C. C. Cohen, None

B. Løyland, None

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