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Arch Intern Med. 2011 Jan 10;171(1):32-8. doi: 10.1001/archinternmed.2010.469.

Infection acquisition following intensive care unit room privatization.

Author information

1
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada. dana.teltsch@mail.mcgill.ca

Abstract

BACKGROUND:

Patients in intensive care units (ICUs) often acquire infections, which impose a heavy human and financial burden. The use of private rooms may reduce the acquisition of certain pathogens, but the limited evidence on this topic is inconsistent.

METHODS:

We compared the rates of acquisition of infectious organisms in an ICU before and after a change from multibed to single rooms. As a control, we used acquisition rates in the ICU of a nearby university teaching hospital, which contained both multibed and single rooms, during the study period. We used a statistical model to adjust for background time trends common to both hospitals.

RESULTS:

The adjusted rate of acquisition of Clostridium difficile, vancomycin-resistant Enterococcus species, and methicillin-resistant Staphylococcus aureus combined decreased by 54% (95% confidence interval [CI], 29%-70%) following the intervention. The methicillin-resistant S aureus acquisition rate fell by 47% (95% CI,1%-71%), the C difficile acquisition rate fell by 43% (95% CI, 7%-65%), and the yeast acquisition rate fell by 51% (95% CI, 34%-64%). Twelve common and likely exogenous organisms and exogenous/endogenous organisms had a reduction in acquisition rates after the intervention; for 6 of them, this reduction was statistically significant. No effect was observed on the acquisition rate of coagulase-negative Staphylococcus species, the most common endogenous organism, for which no change would be expected. The adjusted rate ratio of the average length of stay in the ICU was 10% (95% CI, 0%-19%) lower after the intervention.

CONCLUSION:

Conversion to single rooms can substantially reduce the rate at which patients acquire infectious organisms while in the ICU.

PMID:
21220658
DOI:
10.1001/archinternmed.2010.469
[Indexed for MEDLINE]

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