Relationship between hospital ward design and healthcare-associated infection rates: a systematic review and meta-analysis

Stiller, Andrea; Salm, Florian; Bischoff, Peter; Gastmeier, Petra

Six studies showed a significant benefit of singlepatient bedrooms in reducing the healthcare-associated colonization with MDRO and infection rate [18] [19] [20] [21] [22] [23] . However, three studies found that single-patient rooms are neither a protective factor nor a risk factor for colonization and HAI [16, 17, 24] . A meta-analysis of these nine studies showed a significant benefit of singlepatient bedrooms in reducing the healthcare-associated colonization and infection rate compared with patient care in multiple patient bedrooms or with an open ward design (RR: 0.55, 95% CI: 0.41 to 0.74, Fig. 4) . Separate meta-analysis of two studies which explicitly reported on Fig. 5 ). Six studies which reported on the outcome of bacteremia were also analyzed separately [17] [18] [19] [20] [21] 23] . While three of these six studies revealed a reduced healthcare-associated bacteremia rate associated with patient care in single-patient bedrooms, the other three studies showed no difference in risk. Meta-analysis of these six studies showed a significant benefit of singlepatient bedrooms in reducing the healthcare-associated bacteremia rate compared with patient care in multiple patient bedrooms or with an open ward design (RR: 0.64, 95% CI: 0.53 to 0.76, Fig. 6 ). Overall, the treatment of patients in a single-patient room seems to have a significant benefit in reducing the healthcare-associated colonization with MDRO and the infection rate with any pathogen compared to treatment in multiple patient bedrooms (Figs. 4, 5 and 6).