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Transmission of health care-associated infections from roommates and prior room occupants: a systematic review

Authors Cohen B, Cohen CC, Løyland B, Larson EL

Received 11 October 2016

Accepted for publication 7 February 2017

Published 23 May 2017 Volume 2017:9 Pages 297—310


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

Editor who approved publication: Professor Henrik Toft Sørensen

Bevin Cohen,1 Catherine Crawford Cohen,1 Borghild Løyland,2 Elaine L Larson1

1Columbia University School of Nursing, New York, NY, USA; 2Oslo and Akershus University College, Oslo, Norway

Abstract: Pathogens that cause health care-associated infections (HAIs) are known to survive on surfaces and equipment in health care environments despite routine cleaning. As a result, the infection status of prior room occupants and roommates may play a role in HAI transmission. We performed a systematic review of the literature evaluating the association between patients’ exposure to infected/colonized hospital roommates or prior room occupants and their risk of infection/colonization with the same organism. A PubMed search for English articles published in 1990–2014 yielded 330 studies, which were screened by three reviewers. Eighteen articles met our inclusion criteria. Multiple studies reported positive associations between infection and exposure to roommates with influenza and group A streptococcus, but no associations were found for Clostridium difficile, methicillin-resistant Staphylococcus aureus, Cryptosporidium parvum, or Pseudomonas cepacia; findings were mixed for vancomycin-resistant enterococci (VRE). Positive associations were found between infection/colonization and exposure to rooms previously occupied by patients with Pseudomonas aeruginosa and Acinetobacter baumannii, but no associations were found for resistant Gram-negative organisms; findings were mixed for C. difficile, methicillin-resistant S. aureus, and VRE. Although the majority of studies suggest a link between exposure to infected/colonized roommates and prior room occupants, methodological improvements such as increasing the statistical power and conducting universal screening for colonization would provide more definitive evidence needed to establish causality.

Keywords: health care-associated infections, hospital roommates, prior room occupants, multidrug-resistant organisms

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