Patient Transfers and Clostridioides Difficile Infections: A Case-Control Study

Abstract Background Clostridioides difficile spores are present in the hospital environment. We hypothesized that patient transfers between rooms is an independent risk factor for C. difficile infections (CDI), as this increases the environmental exposition. We performed a retrospective case-control study at a public 400-bed hospital in western Sweden. Methods Hospital-acquired CDI cases at Södra Älvsborg Hospital, Sweden, during two different years (n = 65) were included in the case group. A random, unmatched selection of patients tested negative for CDI served as control group (n = 101). The number of rooms each patient occupied during hospitalization was the primary variable. Odds ratios (OR) for CDI were calculated by simple and multiple logistic regression. Results The number of rooms occupied was not an independent risk factor (OR per room 1.1, 95 % CI: 0.8–1.4) when data were adjusted for duration of hospitalization, which was the only statistically significant variable (OR per additional week of care: 1.7, 95 % CI: 1.2–2.3) in the multiple logistic regression model. The risk associated with the duration of hospitalization was larger among patients who stayed in four or more rooms (OR per additional week of care: 2.5, 95 % CI: 1.1–5.6) than among patients that stayed in one room only (OR per additional week of care: 1.3, 95 % CI: 0.7–2.4). Conclusions The risk for C. difficile infections increase with time of care, and patient transfers might amplify the risk, although we could not prove it to be an independent risk factor in this limited case-control study.