Patients infected with Clostridium difficile are placed in contact isolation precautions in an single occupancy room. Is there any danger to cohorting patients with Clostridium difficile infection (CDI)?
Here is a recent publication in he Journal of Hospital Infection assessing the risk of recurrent disease in patients cohorted with Clostridium difficile associated diarrhea.
In a UK hospital, 138 t (55.6%) CDI patients were admitted to a cohort ward. These patients were more likely to have severe CDI (odds ratio: 1.95; 95% confidence interval: 1.10–3.46; P = 0.022) and receive vancomycin (1.59; 0.94–2.68; P = 0.083) than patients who were not cohorted. Twenty-six patients (10.5%) suffered recurrence (21 cohorted and five not cohorted). Urinary infection on admission (5.16; 2.10–12.64;P < 0.001), cohorting (3.77; 1.37–10.35; P = 0.01) and concomitant antibiotics (2.07; 0.91–4.72; P = 0.083) were associated with increased risk of recurrence. On multivariate analysis, cohorting (3.94; 1.23–12.65;P = 0.021) and urinary infection (4.27; 1.62–11.24; P = 0.003) were significant predictors of recurrence.
Although there are adverse consequences of isolation, cohorting of patients with CDI is not prudent. The benefits outweigh the risk.