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Study of Hospital-Acquired Infections Stresses Need for Tough Cleaning Standards


This article originally appeared in the Fall/Winter 2018 issue of Columbia Nursing magazine.


Exposure to roommates and prior room occupants who harbor pathogenic bacteria may increase a patient’s risk of infection, Columbia Nursing researchers report. Their retrospective analysis of acutecare hospital data found that patients who had a hospital-acquired infection (HAI) had five to six times greater odds than uninfected patients of having been exposed to a roommate or prior bed occupant infected with the same pathogen, indicating the need for hospitals to tighten standards for cleaning and disinfection, according to Associate Research Scientist and principal investigator Bevin Cohen, PhD.

Cohen and colleagues analyzed seven years of data from four inpatient, adult and pediatric acute-care hospitals from the same healthcare network in New York City. They compared patients who had developed a hospital acquired bloodstream, urinary tract, or surgical site infection, or pneumonia, from one of many organisms that are common in inpatient settings, such as Staphylococcus aureus or Klebsiella pneumoniae, with randomly selected controls who had been admitted to the same hospital, during the same fiscal quarter, but who had never tested positive for infection. For both cases and controls, investigators examined exposures during the three- to five-day “incubation period” prior to infection.


Overall, the study included 10,033 cases with HAIs and 10,033 controls. Of these, 136 cases had been exposed to a prior bed occupant with the same organism, compared with 20 controls; 309 cases had been exposed to a roommate with the same organism, compared with 64 controls. “Our findings reveal robust and statistically significant associations, with exposure to an infected or colonized prior bed occupant conferring a nearly six-fold increase in the odds of infection, and exposure to an infected or colonized roommate conferring a nearly five-fold increase,” Cohen wrote.


She noted that more than 700,000 HAIs occur in U.S. hospitals each year, causing $28 billion to $45 billion in excess health spending. Although HAIs are fatal in nearly six percent of cases, they are largely preventable, she added. “If we establish that one of the ways people are getting infections is through shared environments, then we can take a closer look at how we are cleaning and decontaminating hospital environments,” she said.

This study was funded by the National Institute of Nursing Research at the National Institutes of Health and appeared in the May 2018 edition of Infection Control & Hospital Epidemiology.