title: Evaluation of hospital room assignment and acquisition of Clostridium difficile infection.
abstract: OBJECTIVE
  Clostridium difficile spores persist in hospital environments for an extended period. We evaluated whether admission to a room previously occupied by a patient with C. difficile infection (CDI) increased the risk of acquiring CDI.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Medical intensive care unit (ICU) at a tertiary care hospital.
  
  
  METHODS
  Patients admitted from January 1, 2005, through June 30, 2006, were evaluated for a diagnosis of CDI 48 hours after ICU admission and within 30 days after ICU discharge. Medical, ICU, and pharmacy records were reviewed for other CDI risk factors. Admitted patients who did develop CDI were compared with admitted patients who did not.
  
  
  RESULTS
  Among 1,844 patients admitted to the ICU, 134 CDI cases were identified. After exclusions, 1,770 admitted patients remained for analysis. Of the patients who acquired CDI after admission to the ICU, 4.6% had a prior occupant without CDI, whereas 11.0% had a prior occupant with CDI (P = .002). The effect of room on CDI acquisition remained a significant risk factor (P = .008) when Kaplan-Meier curves were used. The prior occupant's CDI status remained significant (p = .01; hazard ratio, 2.35) when controlling for the current patient's age, Acute Physiology and Chronic Health Evaluation III score, exposure to proton pump inhibitors, and antibiotic use.
  
  
  CONCLUSIONS
  A prior room occupant with CDI is a significant risk factor for CDI acquisition, independent of established CDI risk factors. These findings have implications for room placement and hospital design.
authors: Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan 48109-5378, USA.
authors: Megan K
authors: MK
authors: Shaughnessy
authors: Renee L
authors: RL
authors: Micielli
authors: Daryl D
authors: DD
authors: DePestel
authors: Jennifer
authors: J
authors: Arndt
authors: Cathy L
authors: CL
authors: Strachan
authors: Kathy B
authors: KB
authors: Welch
authors: Carol E
authors: CE
authors: Chenoweth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000453:epidemiology* / Q000635:transmission; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000635:transmission; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010362:Patients' Rooms; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult