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Original Investigation
January 10, 2011

Infection Acquisition Following Intensive Care Unit Room Privatization

Author Affiliations

Author Affiliations: Department of Epidemiology, Biostatistics, and Occupational Health (Ms Teltsch and Drs Hanley and Buckeridge) and McGill University Health Centre (Drs Loo, Goldberg, Gursahaney, and Buckeridge), McGill University, Montreal, Quebec, Canada.

Arch Intern Med. 2011;171(1):32-38. doi:10.1001/archinternmed.2010.469

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.