Hospital Patients at Greater Risk for C. diff If Prior Bed Occupant Took Antibiotics

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Hospitalized patients may have elevated risk for Clostridium difficile infection (CDI) if the patient who occupied the bed before them was taking antibiotics, suggests a retrospective study in JAMA Internal Medicine.

Using New York hospital records, researchers assessed 100,000 pairs of patients who sequentially occupied the same hospital bed. Patients in beds that had most recently been used by someone taking antibiotics (besides those used to treat C. difficile, such as oral vancomycin and metronidazole) had a higher incidence of CDI than those whose prior bed occupant hadn't taken antibiotics (0.72% vs. 0.43%). The association was still significant after excluding prior patients who had C. diff.

The authors conclude: "The increase in risk was small but is of potential importance given the frequency of use of antibiotics in the hospital. These data imply that patient-to-patient transmission of C. difficile or other bacteria that mediate susceptibility to CDI takes place in the nonoutbreak setting and in the face of a multifaceted effort seeking to prevent health care-associated CDI."