By Ethan Covey
People who stay in hospital beds, which were previously slept in by a patient with Clostridioides difficile have a higher risk of developing hospital-acquired C. difficile infection (HO-CDI), according to a recent study.
The findings show that increased disinfection measures may be needed to reduce rates of HO-CDI (Infect Cont Hosp Epidemiol 2024;45[5]:599-603).
“Our research highlights the complexity of C. difficile transmission and the integral role hospital beds play,” said Lucy S. Witt, MD, an assistant professor in the Division of Infectious Diseases at Emory University School of Medicine, in Atlanta. “We hope to encourage infection prevention teams to ensure that hospital beds are appropriately cleaned, and that manufacturers consider products that target hospital beds and mattresses when developing new products.”
The retrospective, observational cohort study used data from real-time bed trackers that were installed in two hospitals. Patients who resided in the beds from April 1, 2018, to Aug. 31, 2019, were identified. Patients were defined as being exposed to a potentially contaminated bed or hospital room if, within the previous seven days, they had resided in a hospital bed or room that had held an occupant with a positive C. difficile test in the previous 90 days.
A total of 25,032 hospital encounters representing 18,860 unique patients were included in the analysis. Among 3,155 stool samples that were collected and processed for C. difficile, 241 (7.6%) were positive. They identified 237 hospital encounters where HO-CDI was identified.
Exposure to a contaminated bed was associated with HO-CDI in both unadjusted (odds ratio [OR], 1.8; 95% CI, 1.4-2.31) and adjusted analyses (OR, 1.5; 95% CI, 1.2-2.0). Overall, a higher Elixhauser Comorbidity Index score, longer time at risk, admission to the ICU or hospital, and receipt of antibiotics or proton pump inhibitors were associated with exposure to a contaminated bed.
“Further study is needed to tease out the relative importance of surfaces in the hospital room (such as bed rails, mattresses, countertops, light switches, etc.) in C. difficile transmission, which could be explored both on a microbiological level and through modeling,” Dr. Witt said. “We are also excited about the expanding field of human factors research that will bring understanding to how patient and healthcare worker interactions with these surfaces create opportunity for unintended transmission.”
Dr. Witt reported no relevant financial disclosures.
