Clostridioides difficile infection (CDI) in a previous room occupant predicts CDI in subsequent room occupants across different hospital settings

Am J Infect Control. 2022 Dec;50(12):1352-1354. doi: 10.1016/j.ajic.2022.02.006. Epub 2022 Feb 23.


Background: Previous single-center studies suggest that exposure to a room previously occupied by a patient with CDI may increase the risk of CDI in subsequent patients. We evaluated the risk of previous room occupant on CDI risk across 5 adult hospitals.

Methods: This is a non-concurrent cohort study of adult inpatients admitted to 5 hospitals. Exposed rooms were identified as being occupied by a patient diagnosed with CDI and a logistic regression was performed to assess if staying in an exposed room increases the risk of CDI in subsequent patients.

Results: Patients admitted to a room that was previously occupied by a patient with CDI had a 27% increased odds of subsequently being diagnosed with CDI (odds ratio (OR)=1.269; 95% confidence interval (CI)= 1.12-1.44) if exposed within the last 90 days and 40% increased odds (OR=1.401; 95% CI= 1.25-1.57) if exposed in the last 365 days after controlling for previous admissions and length of stay. Cumulative patient-day exposure to previously CDI-positive occupied rooms within both 90 and 365 days were also found to be independently significant, with a 4.5% (OR 1.045; 95% CI = 1.03-1.06) and 4.2% (OR 1.042; 95% CI = 1.03-1.06) increase in odds of CDI with each day of exposure respectively.

Discussion/conclusions: This study adds further evidence that hospital environment in patient rooms may contribute to risk for CDI.

Keywords: Clostridioides Difficile; Hospital Environment; Previous Room Occupant.

MeSH terms

  • Adult
  • Clostridioides difficile*
  • Clostridium Infections* / epidemiology
  • Cohort Studies
  • Cross Infection* / epidemiology
  • Hospitals
  • Humans
  • Retrospective Studies
  • Risk Factors