Risk of organism acquisition from prior room occupants: An updated systematic review

Brett G Mitchell; Julee McDonagh; Stephanie J Dancer; Sindi Ford; Jenny Sim; Bismi Thottiyil Sultanmuhammed Abdul Khadar; Philip L Russo; Jean-Yves Maillard; Helen Rawson; Katrina Browne; Martin Kiernan

doi:10.1016/j.idh.2023.06.001

Risk of organism acquisition from prior room occupants: An updated systematic review

Infect Dis Health. 2023 Nov;28(4):290-297. doi: 10.1016/j.idh.2023.06.001. Epub 2023 Jun 27.

Authors

Affiliations

¹ Central Coast Local Health District, Gosford Hospital, NSW, Australia; School of Nursing, Avondale University, Lake Macquarie, NSW, Australia; Nursing and Midwifery, Monash University, Victoria, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia. Electronic address: https://twitter.com/1healthau.
² Centre for Chronic and Complex Care, Blacktown Hospital, Western Sydney Local Health District, NSW, Australia; School of Nursing, Faculty of Science, Medicine and Health, The University of Wollongong, NSW, Australia. Electronic address: https://twitter.com/JuleeMcDonagh.
³ Department of Microbiology, Hairmyres Hospital, Glasgow, and Edinburgh Napier University, Glasgow, UK.
⁴ Central Coast Local Health District, Gosford, NSW, Australia; School of Health Science, University of Newcastle, Ourimbah, NSW, Australia.
⁵ WHO Collaborating Centre for Nursing, Midwifery & Health Development, University of Technology Sydney, NSW Australia; School of Nursing & Midwifery, University of Newcastle, NSW Australia; School of Nursing, University of Wollongong, NSW Australia; Australian Health Services Research Institute, University of Wollongong, NSW Australia. Electronic address: https://twitter.com/jennysim_1.
⁶ Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Nursing & Midwifery, University of Newcastle, NSW Australia.
⁷ School of Nursing, Avondale University, Lake Macquarie, NSW, Australia; Nursing and Midwifery, Monash University, Victoria, Australia; Cabrini Research, Cabrini Health, Victoria, Australia. Electronic address: https://twitter.com/PLR_aus.
⁸ School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.
⁹ Nursing and Midwifery, Monash University, Victoria, Australia. Electronic address: https://twitter.com/DrHelenRawson.
¹⁰ Central Coast Local Health District, Gosford Hospital, NSW, Australia; School of Nursing, Avondale University, Lake Macquarie, NSW, Australia. Electronic address: https://twitter.com/savvy_science.
¹¹ School of Nursing, Avondale University, Lake Macquarie, NSW, Australia; Richard Wells Research Centre, University of West London, UK. Electronic address: https://twitter.com/emrsa15.

PMID: 37385863
DOI: 10.1016/j.idh.2023.06.001

Abstract

Background: Evidence from a previous systematic review indicates that patients admitted to a room where the previous occupant had a multidrug-resistant bacterial infection resulted in an increased risk of subsequent colonisation and infection with the same organism for the next room occupant. In this paper, we have sought to expand and update this review.

Methods: A systematic review and meta-analysis was undertaken. A search using Medline/PubMed, Cochrane and CINHAL databases was conducted. Risk of bias was assessed by the ROB-2 tool for randomised control studies and ROBIN-I for non-randomised studies.

Results: From 5175 identified, 12 papers from 11 studies were included in the review for analysis. From 28,299 patients who were admitted into a room where the prior room occupant had any of the organisms of interest, 651 (2.3%) were shown to acquire the same species of organism. In contrast, 981,865 patients were admitted to a room where the prior occupant did not have an organism of interest, 3818 (0.39%) acquired an organism(s). The pooled acquisition odds ratio (OR) for all the organisms across all studies was 2.45 (95% CI: 1.53-3.93]. There was heterogeneity between the studies (I² 89%, P < 0.001).

Conclusion: The pooled OR for all the pathogens in this latest review has increased since the original review. Findings from our review provide some evidence to help inform a risk management approach when determining patient room allocation. The risk of pathogen acquisition appears to remain high, supporting the need for continued investment in this area.

Keywords: Acquisition; Cleaning; Cross infection; Infection control; Prior room occupancy.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Cross Infection* / microbiology
Hospitalization
Humans
Patients' Rooms