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Updated: Oct 1, 2026
Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis
B G Mitchell1, S J Dancer2, M Anderson3
1Avondale College of Higher Education, Faculty of Arts, Nursing and Theology, Wahroonga, NSW, Australia; Faculty of Health Sciences, Australian Catholic University, Watson, Australian Capital Territory, Australia.
Abstract:
A systematic review and meta-analysis was conducted to determine the risk of pathogen acquisition for patients associated with prior room occupancy. The analysis was also broadened to examine any differences in acquisition risk between Gram-positive and Gram-negative organisms. A search using Medline/PubMed, Cochrane and CINHAL yielded 2577 citations between 1984 and 2014. Reviews were assessed in accordance with the international prospective register of systematic reviews (PROSPERO). Just seven articles met the inclusion criteria, namely: (a) papers were peer reviewed, (b) pathogen acquisition prevalence rates were reported, (c) articles were written in English; and (d) had minimal or no risk of bias based on the Newcastle-Ottawa Scale (NOS). One study was an extension of a previous study and was discarded. Employing NOS provided little difference between the studies, with five studies receiving eight-star and two studies receiving seven-star ratings, respectively. Overall, pooled acquisition odds ratio for study pathogens (meticillin-resistant Staphylococcus aureus; vancomycin-resistant enterococcus; Clostridium difficile; acinetobacter; extended-spectrum β-lactamase-producing coliforms; pseudomonas) was 2.14 [95% confidence interval (CI): 1.65-2.77]. When comparing data between Gram-positive and Gram-negative organisms, the pooled acquisition odds ratio for Gram-negatives was 2.65 (95% CI: 2.02-3.47) and 1.89 (95% CI: 1.62-2.21) for Gram positives. The findings have important implications for infection control professionals, environmental cleaning services and patients, since current practices fail to adequately reduce acquisition risk. Although there may be non-preventable sources of acquisition, revised practices require collaborative work between all responsible staff in order to reduce this risk to a minimum.
Insights
Patients face a doubled risk of acquiring pathogens from previous room occupants. This risk is higher for Gram-negative bacteria than Gram-positive ones, indicating current infection control practices are insufficient.
Area of Science:
- Infection Control
- Epidemiology
- Microbiology
Background:
- Healthcare-associated infections (HAIs) pose a significant threat to patient safety.
- The role of environmental contamination and prior room occupancy in pathogen transmission is a critical concern.
- Existing infection control measures may not sufficiently mitigate the risk of pathogen acquisition from the hospital environment.
Purpose of the Study:
- To systematically review and meta-analyze the risk of pathogen acquisition for patients from prior room occupancy.
- To compare the acquisition risk between Gram-positive and Gram-negative organisms.
- To evaluate the effectiveness of current infection control practices in reducing environmental pathogen transmission.
Main Methods:
- A comprehensive literature search was conducted across Medline/PubMed, Cochrane, and CINHAL databases (1984-2014).
- Seven peer-reviewed studies meeting strict inclusion criteria (reported prevalence, English language, minimal bias via Newcastle-Ottawa Scale) were included.
- A meta-analysis was performed to calculate pooled odds ratios for pathogen acquisition.
Main Results:
- The overall pooled odds ratio for acquiring study pathogens from prior room occupancy was 2.14.
- The acquisition odds ratio was higher for Gram-negative organisms (2.65) compared to Gram-positive organisms (1.89).
- Included studies demonstrated high quality, with most achieving 7 or 8 stars on the Newcastle-Ottawa Scale.
Conclusions:
- Patients have a significantly increased risk of acquiring pathogens from previous room occupants.
- Current infection control and environmental cleaning practices are inadequate in minimizing pathogen acquisition risk.
- A collaborative, revised approach involving all staff is necessary to reduce transmission risks.
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