Do Treatment Beds Matter for C. difficile Patients?

Mortality rates for patients with Clostridium difficile (C. difficile) infections decreased when treated in the common isolation unit, according to a new report.

Researchers from University Hospital Dr. José Eleuterio González in Mexico, used clinical characteristics and outcomes of C. difficile infections in order to compare results of those treated in the common isolation unit and those who treated in the same bed in which they received the diagnosis.

The researchers included patients diagnosed between January 2014 and December 2016 at a 500-bed hospital.

A total of 176 patients were diagnosed with C. difficile during the study period. Of those, about half were transferred to the common isolation unit while the rest remained in their original bed.

Those that remained in their beds did so for various reasons, including: the isolation unit was full at the time of diagnosis, patients were from surgical wards, were already in single rooms, or were from the emergency room, intensive care unit, neurology or gynecology wards.

One patient was transferred to another hospital at the time of diagnosis.

The common isolation unit group received an average of 8.2 days of antibiotic treatment, compared to the 9.2 days of care in the original bed group.

About a quarter of the common isolation unit patients underwent fecal microbiota transplant (FMT), while only 4% in the original bed group underwent FMT.

Additionally, patients in the isolation unit had higher rates of recurrence than the original bed group, but it was not statistically significant.

After further analysis, the researchers learned variables such as history of previous surgery, longer duration of treatment, and 30-day mortality were also present in the original bed group.

The researchers attributed these major differences in reduced mortality to closer contact with the medical team and a specific medical staff assigned to these patients, study author Adrian Camacho-Ortiz, PhD told MD Magazine.

“Hospitals and physicians with a significant number of C. difficile infected patients can take our data to implement a similar scenario were a group of patients can be treated in a multiple bed room with a reduction in antibiotic length, fewer deaths and possibly lower cost,” Dr. Camacho added.

Some of the issues related to isolating patients include hospital space. Though having a specific unit for C. difficile management is advantageous, it can foster a lower nurse to patient ratio, and a specific physician per shift, which could positively influence mortality and lower treatment duration throughout the course of analysis. These factors would not be seen among patients who were treated in their original beds of diagnosis.

The paper, titled “Outcomes of Clostridium difficile-infected patients managed in a common isolation unit compared with isolation in their bed of diagnosis,” was published in the American Journal of Infection Control.