NEW YORK (Reuters Health) - Intensive care unit (ICU) patients placed in private rooms may pick up less than half as many infections as those in rooms with multiple beds, hints a new Canadian study.
Nearly one in every three ICU patients will catch a new bug in the hospital, increasing the average time they have to stay there by more than a week. All together, these hospital-acquired infections cost the U.S. health care system an estimated $3.5 billion per year.
Prior research has looked at private rooms as a barrier to the spread of potentially deadly infections in hospitals. But these studies were inconclusive and focused on just one or two types of bacteria, rather than all of the infectious organisms that could be affected by such an intervention, according to lead researcher Dana Teltsch of McGill University, in Quebec.
“We had a great opportunity to study the effect of private rooms on infection acquisition rates because we could compare two close-by university hospitals -- less than a mile apart -- that serve the same area,” she told Reuters Health in an e-mail.
Teltsch and her team analyzed data from 19,343 ICU admissions between 2000 and 2005 at the two Montreal hospital centers, one of which underwent an overnight switch to only private ICU rooms in March 2002.
The team used infection rates at the hospital that maintained a mix of shared and private rooms as an approximation for how the other one might have looked without the change. The two hospitals shared many factors including infection control practices, as well as an epidemic of Clostridium difficile during the course of the study, said Teltsch.
In total, the hospitals recorded 6,597 bacteria, yeast and fungi infections over the 5-year period.
For the three bacteria that were at the focus of infection control -- methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus species (VRE) and Clostridium difficile -- the combined risk of a patient acquiring an infection fell by 54 percent after the transition to private rooms, taking into account the infection rate at the comparison hospital.
Further, the average patient in a private room stayed in the ICU 10 percent fewer days after the conversion, report the researchers in the Archives of Internal Medicine.
“We think private rooms enabled better hygiene,” noted Teltsch.
For example, the researchers point out that private rooms may allow for more frequent hand washing and easier cleaning. The isolation strategy could also reduce the number of patient transfers between rooms.
However, Teltsch suggested that there are many other costs and benefits that would need to be considered before making such a switch, including the price tag and feasibility of converting shared ICU rooms into private ones. Her team’s study focused only on the rates of infection and lengths of stay.
Further research is also needed to better understand organisms’ routes of transmission in order to develop ways to better thwart their spread, according to the researchers.
For the current study, Teltsch and her colleagues got their data from several different databases maintained by each hospital to keep track of patient admissions, moves, discharges and laboratory-confirmed infections.
Such hospital-wide information systems are increasingly being introduced in both the U.S. and Canada, said Teltsch, so this kind of data is expected to become more readily available.
“This has a lot of potential not only as the basis for future studies but for improvement of infection control practices and many other aspects of patient care,” she added.
SOURCE: bit.ly/7qXyI Archives of Internal Medicine, online January 10, 2011.
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