Welcome to Study of the Week from Patient Worthy. In this segment, we select a study we posted about from the previous week that we think is of particular interest or importance and go more in-depth. In this story we will talk about the details of the study and explain why it’s important, who will be impacted, and more.
If you read our short form research stories and find yourself wanting to learn more, you’ve come to the right place.
This week’s study is…
The role of the hospital bed in hospital-onset Clostridioides difficile: A retrospective study with mediation analysis
We previously published about this research in a story titled “Contaminated Bed Use in Hospitals Significantly Increases Risk of C. Diff Infection” which can be found here. The study was originally published in the scientific journal Infection Control & Hospital Epidemiology. You can read the abstract of the study here.
This research was affiliated with the Emory University School of Medicine.
What Happened?
The Emory Johns Creek Hospital recently decided to replace the mattresses in its hospital beds. There have been reports circulating about how mattress covers routinely failed to prevent potentially infectious fluids from leaking into the mattresses. The researchers sought to understand how a contaminated mattress could play a role in the spread of infectious disease. One of the more common infections associated with hospitalization is Clostridioides difficile, or C. diff, with around 30% of cases occurring due to exposure in a medical center.
To evaluate the impact of contaminated mattresses on C. diff infection rates, the team used a real-time tracking system to monitor the movement of hospital beds at two different academic hospitals from April 2018 to August 2019. Patients were regarded as exposed to a contaminated mattress if they had stayed in bed or room that had held a prior C. diff patient in the past 90 days, and they had stayed in the room within seven days prior to receiving a diagnosis themselves.
Data from 18,860 patients was utilized in the study, and from that data a total of 237 cases of hospital-acquired C. diff were identified. The team found that exposure to a bed that was considered contaminated resulted in doubling of an individual’s risk of developing C. diff. This association was consistent even after the scientists accounted for other factors, such as ICU admission prior to infection and time at risk.
The team found that the median time from a previous occupant’s diagnosis and that of the next occupant’s was 38.5 days. Meanwhile, the median time between the previous patient’s last day in the bed and the next occupant’s diagnosis was 34.5 days. Overall, the researchers concluded from these findings that it was clear that contaminated bedding doubled the risk of C. diff infection in the hospital setting.
Why Does it Matter?
While hospitals are generally intended to be sanitary spaces where people with serious illness or who need complex care can receive the treatment they need to recover safely, staying in the hospital, especially for an extended period of time, also carries risk of disease, particularly infections such as C. diff.
Hospitals should be taking as many steps and measures as possible to maintain a relatively sterile environment that protects patients from contracting illness. The data from this research serves to highlight the ways in which infectious disease can spread in the hospital setting and inform methods used for prevention.
“C. difficile can contaminate multiple surfaces in a patient’s room, especially the bed, and subsequent bed or room occupants are at risk for developing this infection. Infection preventionists and environmental service professionals need to take this into consideration when planning disinfection and decontamination processes for rooms and equipment that have interacted with individuals with C. difficile infections.” – Lucy S. Witt, MD, MPH, study author, assistant professor of medicine, Emory University School of Medicine, director of antimicrobial stewardship, epidemiologist, Emory Johns Creek Hospital
About Clostridioides Difficile (C. Diff)
Infection with Clostridioides difficile (C. diff), a spore forming, gram-positive bacterium, can lead to a range of symptoms that can become severe and even life-threatening. The infection is typically spread through infected fecal matter and is also associated with antibiotics use. This bacterium can spread relatively easily and can easily contaminate surfaces. Symptoms of C. diff include mild diarrhea, fever, abdominal pain, nausea, appetite loss, colon inflammation (which can become severe), and a distinct odor to the feces resembling that of horses. More frequent bouts of diarrhea are considered indicators of more serious disease. Certain antibiotics can treat the infection, but not all patients respond. Other options include surgery and fecal microbiota transplant. To learn more about C. diff, click here.
