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Published in: Antimicrobial Resistance & Infection Control 1/2017

Open Access 01-12-2017 | Letter to the Editor

Relationship between hospital ward design and healthcare associated infection rates: what does the evidence really tell us? Comment on Stiller et al. 2016

Authors: Jennie Wilson, Andrew Dunnett, Heather Loveday

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2017

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Abstract

The systematic review published by Stiller et al. in Antimicrobial Resistance & Infection Control in November 2016 concludes that single-patient bedrooms confer a significant benefit for protecting patients from healthcare associated infection and colonization. This conclusion is not substantiated by the evidence included in their review which has been largely drawn from uncontrolled before and after studies in the absence of a transparent assessment of the risk of bias. There are also errors in the analysis of supporting data. Evaluating the specific impact of single rooms on preventing transmission from a sound epidemiological perspective is essential to assure safe and effective care and a clear evidence-base for infection prevention and control advice.
Literature
1.
go back to reference Stiller A, Salm F, Bischoff P, Gastmeier P. Relationship between hospital ward design and healthcare associated infection rates: a systematic review and meta-analysis. Anti Res Infect Control. 2016;5:51.CrossRef Stiller A, Salm F, Bischoff P, Gastmeier P. Relationship between hospital ward design and healthcare associated infection rates: a systematic review and meta-analysis. Anti Res Infect Control. 2016;5:51.CrossRef
2.
go back to reference Ben-Abraham R, et al. Do isolation rooms reduce the rate of nosocomial infections in the pediatric intensive care unit? J Crit Care. 2002;17(3):176–80.CrossRefPubMed Ben-Abraham R, et al. Do isolation rooms reduce the rate of nosocomial infections in the pediatric intensive care unit? J Crit Care. 2002;17(3):176–80.CrossRefPubMed
3.
go back to reference McManus AT, et al. A decade of reduced gram-negative infections and mortality associated with improved isolation of burned patients. Arch Surg. 1994;129(12):1306–9.CrossRefPubMed McManus AT, et al. A decade of reduced gram-negative infections and mortality associated with improved isolation of burned patients. Arch Surg. 1994;129(12):1306–9.CrossRefPubMed
4.
go back to reference Mulin B, et al. Association of private isolation rooms with ventilator associated Acinetobacter baumanii pneumonia in a surgical intensive-care unit. Infect Control Hosp Epidemiol. 1997;18(7):499–503.CrossRefPubMed Mulin B, et al. Association of private isolation rooms with ventilator associated Acinetobacter baumanii pneumonia in a surgical intensive-care unit. Infect Control Hosp Epidemiol. 1997;18(7):499–503.CrossRefPubMed
5.
go back to reference Lazar I, et al. Impact of conversion from an open ward design paediatric intensive care unit environment to all isolated rooms environment on incidence of bloodstream infections and antibiotic resistance in Southern Israel (2000 to 2008). Anaesth Intensive Care. 2015;43(1):34–41.PubMed Lazar I, et al. Impact of conversion from an open ward design paediatric intensive care unit environment to all isolated rooms environment on incidence of bloodstream infections and antibiotic resistance in Southern Israel (2000 to 2008). Anaesth Intensive Care. 2015;43(1):34–41.PubMed
6.
go back to reference Ellison J, et al. Hospital ward design and prevention of hospital-acquired infections: A prospective clinical trial. Can J Infect Dis Med Microbiol. 2014;25(5):265–70.PubMedPubMedCentral Ellison J, et al. Hospital ward design and prevention of hospital-acquired infections: A prospective clinical trial. Can J Infect Dis Med Microbiol. 2014;25(5):265–70.PubMedPubMedCentral
7.
go back to reference Vietri NJ, et al. The effect of moving to a new hospital facility on the prevalence of methicillin-resistant Staphylococcus aureus. Am J Infect Control. 2004;32(5):262–7.CrossRefPubMed Vietri NJ, et al. The effect of moving to a new hospital facility on the prevalence of methicillin-resistant Staphylococcus aureus. Am J Infect Control. 2004;32(5):262–7.CrossRefPubMed
9.
go back to reference Levin PD, et al. Improved ICU design reduces acquisition of antibiotic resistant bacteria: a quasi-experimental observational study. Crit Care. 2011;15(5):R211.CrossRefPubMedPubMedCentral Levin PD, et al. Improved ICU design reduces acquisition of antibiotic resistant bacteria: a quasi-experimental observational study. Crit Care. 2011;15(5):R211.CrossRefPubMedPubMedCentral
10.
go back to reference Julian S, et al. Impact of neonatal intensive care bed configuration on rates of late-onset bacterial sepsis and methicillin-resistant Staphylococcus aureus colonization. Infect Control Hosp Epidemiol. 2015;36(10):1173–82.CrossRefPubMedPubMedCentral Julian S, et al. Impact of neonatal intensive care bed configuration on rates of late-onset bacterial sepsis and methicillin-resistant Staphylococcus aureus colonization. Infect Control Hosp Epidemiol. 2015;36(10):1173–82.CrossRefPubMedPubMedCentral
11.
go back to reference Bracco D, et al. Single rooms may help to prevent nosocomial bloodstream infection and cross-transmission of methicillin-resistant Staphylococcus aureus in intensive care units. Intensive Care Med. 2007;33(5):836–40.CrossRefPubMed Bracco D, et al. Single rooms may help to prevent nosocomial bloodstream infection and cross-transmission of methicillin-resistant Staphylococcus aureus in intensive care units. Intensive Care Med. 2007;33(5):836–40.CrossRefPubMed
12.
go back to reference Wilson APR, Livermore DM, Otter JA, et al. Prevention and control of multi-drug-resistant Gram-negative bacteria: recommendations from a Joint Working Party. J Hosp Infect. 2016;91:S1–44.CrossRef Wilson APR, Livermore DM, Otter JA, et al. Prevention and control of multi-drug-resistant Gram-negative bacteria: recommendations from a Joint Working Party. J Hosp Infect. 2016;91:S1–44.CrossRef
13.
go back to reference Saint S, Higgins LA, Nallamothu BK, Chenoweth C. Do physicians examine patients in contact isolation less frequently? A brief report. Am J Infect Control. 2003;31(6):354–6.CrossRefPubMed Saint S, Higgins LA, Nallamothu BK, Chenoweth C. Do physicians examine patients in contact isolation less frequently? A brief report. Am J Infect Control. 2003;31(6):354–6.CrossRefPubMed
14.
go back to reference Stern JAC, Hernan MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919.CrossRef Stern JAC, Hernan MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919.CrossRef
Metadata
Title
Relationship between hospital ward design and healthcare associated infection rates: what does the evidence really tell us? Comment on Stiller et al. 2016
Authors
Jennie Wilson
Andrew Dunnett
Heather Loveday
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2017
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-017-0226-8

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