Intensive Care Medicine

, Volume 33, Issue 5, pp 836–840 | Cite as

Single rooms may help to prevent nosocomial bloodstream infection and cross-transmission of methicillin-resistant Staphylococcus aureus in intensive care units

  • David Bracco
  • Marc-Jacques Dubois
  • Redouane Bouali
  • Philippe Eggimann
Brief Report



Nosocomial infections remain a major problem in intensive care units. Several authorities have recommended housing patients in single rooms to prevent cross-transmission of potential pathogens, but this issue is currently debated. The aim of the present study was to compare the rate of nosocomial cross-contamination between patients hosted in single rooms versus bay rooms.


Prospective observational data acquisition over 2.5 years.


A 14-bed medico-surgical ICU, composed of six single-bed rooms plus a six-bed and a two-bed bay room served by the same staff.

Patients and participants

All patients admitted from 1 July 2002 to 31 December 2004.



Measurements and results

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in admitted patients was 1.1% and acquisition rate 2.4%. The incidence density of MRSA acquisition was 4.1 [95% CI 2.7–6.3]/1,000 patient-days in bay rooms versus 1.3 [0.5–3.4]/1,000 patient-days in single rooms (p < 0.001). Pseudomonas spp. acquisition rate was 3.9 [2.5–6.1]/1,000 patient-days in bay rooms versus 0.7 [0.2–2.4]/1,000 patient-days in single rooms (p < 0.001), and Candida spp. colonization was 38.4 [33.3–44.1]/1,000 patient-days in bay rooms versus 13.8 [10.2–18.6]/1,000 patient-days (p < 0.001). By multivariate analysis, the relative risk of MRSA, Pseudomonas aeruginosa and Candida spp. acquisition in single rooms or cubicles versus bay rooms was 0.65, 0.61 and 0.75 respectively.


These data suggest that in an institution where MRSA is not hyperendemic, infection control measures may be more effective to prevent cross-transmission of microorganisms in patients housed in single rooms.


Infection control Cross infection/epidemiology/*etiology/*prevention & control Handwashing Critical care Hygiene Prospective studies 


  1. 1.
    Vincent J (2003) Nosocomial infections in adult intensive-care units. Lancet 361:2068–2077PubMedCrossRefGoogle Scholar
  2. 2.
    O'Connell NH, Humphreys H (2000) Intensive care unit design and environmental factors in the acquisition of infection. J Hosp Infect 45:255–262PubMedCrossRefGoogle Scholar
  3. 3.
    Dettenkofer M, Seegers S, Antes G, Motschall E, Schumacher M, Daschner FD (2004) Does the architecture of hospital facilities influence nosocomial infection rates? A systematic review. Infect Control Hosp Epidemiol 25:21–25PubMedCrossRefGoogle Scholar
  4. 4.
    Vietri N, Dooley D, Davis C, Longfield J, Meier P (2004) The effect of moving to a new hospital, facility on the prevalence of methicillin resistant Staphylococcus aureus. Am J Infect Control 32:262–267PubMedCrossRefGoogle Scholar
  5. 5.
    Cepeda J, Whitehouse T, Cooper B et al (2005) Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive-care units: prospective two-centre study. Lancet 365:295–304PubMedGoogle Scholar
  6. 6.
    Cooper BS, Stone SP, Kibbler CC, Cookson BD, Roberts JA, Medley GF, Duckworth G, Lai R, Ebrahim S (2004) Isolation measures in the hospital management of methicillin resistant Staphylococcus aureus (MRSA): systematic review of the literature. Br Med J 329:533CrossRefGoogle Scholar
  7. 7.
    Garner J, Jarvis W, Emori T, Horan T, Hughes J (1996) CDC definitions for nosocomial infections. In: Olmsted R (ed) APIC infection control and applied epidemiology: principles and practice. Mosby, St. Louis, pp. A1–A20Google Scholar
  8. 8.
    Garner JS, Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. CDC Bethesda. [] accessed 2-13-2007
  9. 9.
    Boyce JM, Pittet D (2002) Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep 51:1–45PubMedGoogle Scholar
  10. 10.
    Gastmeier P, Schwab F, Geffers C, Ruden H (2004) To isolate or not to isolate? Analysis of data from the German Nosocomial Infection Surveillance System regarding the placement of patients with methicillin-resistant Staphylococcus aureus in private rooms in intensive care units. Infect Control Hosp Epidemiol 25:109–113PubMedCrossRefGoogle Scholar
  11. 11.
    Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV (2000) Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet 356:1307–1312PubMedCrossRefGoogle Scholar
  12. 12.
    Lucet JC, Paoletti X, Lolom I, Paugam-Burtz C, Trouillet JL, Timsit JF, Deblangy C, Andremont A, Regnier B (2005) Successful long-term program for controlling methicillin-resistant Staphylococcus aureus in intensive care units. Intensive Care Med 31:1051–1057PubMedCrossRefGoogle Scholar
  13. 13.
    Beovic B, Bufon T, Cizman M, Kolman J, Skerl M (2005) Isolation of patients with MRSA infection. Lancet 365:1304PubMedCrossRefGoogle Scholar
  14. 14.
    Brun-Buisson C, Girou E (2005) Isolation of patients with MRSA infection. Lancet 365:1303PubMedCrossRefGoogle Scholar
  15. 15.
    Lessing MPA, Loveland RC (2005) Isolation of patients with MRSA infection. Lancet 365:1303PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • David Bracco
    • 1
    • 2
  • Marc-Jacques Dubois
    • 2
  • Redouane Bouali
    • 3
  • Philippe Eggimann
    • 4
  1. 1.Department of AnaesthesiaMontreal General Hospital, McGill University Health CenterMontrealCanada
  2. 2.Intensive Care Unit, Department of MedicineMontreal University HospitalMontrealCanada
  3. 3.Intensive Care Unit, Department of MedicineOttawa General & Civic HospitalOttawaCanada
  4. 4.Department of Intensive Care MedicineCentre Hospitalier Universitaire Vaudois (CHUV)LausanneSwitzerland

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