title: Relationship between sharps disposal containers and Clostridium difficile infections in acute care hospitals.
abstract: BACKGROUND
  Sharps disposal containers are ubiquitous in health care facilities; however, there is paucity of data on their potential role in pathogen transmission. This study assessed the relationship between use of single-use versus reusable sharps containers and rates of Clostridium difficile infections in a national sample of hospitals.
  
  
  METHODS
  A 2013 survey of 1,990 hospitals collected data on the use of sharps containers. Responses were linked to the 2012 Medicare Provider Analysis and Review dataset. Bivariate and multivariable negative binomial regression were conducted to examine differences in C difficile rates between hospitals using single-use versus reusable containers.
  
  
  RESULTS
  There were 604 hospitals who completed the survey; of these, 539 provided data on use of sharps containers in 2012 (27% response rate). Hospitals had, on average, 289 beds (SD ± 203) and were predominantly non-for-profit (67%) and nonteaching (63%). Most used reusable sharps containers (72%). In bivariate regression, hospitals using single-use containers had significantly lower rates of C difficile versus hospitals using reusable containers (incidence rate ratio [IRR] = 0.846, P = .001). This relationship persisted in multivariable regression (IRR = 0.870, P = .003) after controlling for other hospital characteristics.
  
  
  CONCLUSIONS
  This is the first study to show a link between use of single-use sharps containers and lower C difficile rates. Future research should investigate the potential for environmental contamination of reusable containers and the role they may play in pathogen transmission.
authors.affiliation: Jefferson College of Nursing, Thomas Jefferson University, Philadelphia, PA. Electronic address: monika.pogorzelska-maziarz@jefferson.edu.
authors.forename: Monika
authors.initials: M
authors.lastname: Pogorzelska-Maziarz
mesh_terms: D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology*; D003428:Cross Infection / Q000139:chemically induced* / Q000453:epidemiology* / Q000382:microbiology; D003967:Diarrhea / Q000139:chemically induced* / Q000453:epidemiology* / Q000382:microbiology; D006761:Hospitals; D006801:Humans; D017744:Medical Waste Disposal / Q000379:methods*; D013223:Statistics as Topic
chemical_list: D017744:Medical Waste Disposal
keywords: Clostridium difficile infections; Environmental contamination; Sharps disposal containers