Single rooms may help to prevent nosocomial bloodstream infection and cross-transmission of methicillin-resistant Staphylococcus aureus in intensive care units
- 483 Downloads
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.
KeywordsInfection control Cross infection/epidemiology/*etiology/*prevention & control Handwashing Critical care Hygiene Prospective studies
- 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.Garner JS, Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. CDC Bethesda. [http://www.cdc.gov/ncidod/dhqp/gl_isolation.html] accessed 2-13-2007
- 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.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