期刊
AMERICAN JOURNAL OF INFECTION CONTROL
卷 41, 期 8, 页码 668-673出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.ajic.2013.01.013
关键词
Vancomycin-resistant Enterococcus; Hospitals; Health care-associated infections; Modeling; Simulation
资金
- National Institute of General Medical Sciences Models of Infectious Disease Agent Study grants [1U54GM088491-0109, 1U01 GM076672]
- National Institutes of Health [K23AI64161]
- Pennsylvania Department of Health
Background: Because patients can remain colonized with vancomycin-resistant enterococci (VRE) for long periods of time, VRE may spread from one health care facility to another. Methods: Using the Regional Healthcare Ecosystem Analyst, an agent-based model of patient flow among all Orange County, California, hospitals and communities, we quantified the degree and speed at which changes in VRE colonization prevalence in a hospital may affect prevalence in other Orange County hospitals. Results: A sustained 10% increase in VRE colonization prevalence in any 1 hospital caused a 2.8% (none to 62%) average relative increase in VRE prevalence in all other hospitals. Effects took from 1.5 to >10 years to fully manifest. Larger hospitals tended to have greater affect on other hospitals. Conclusions: When monitoring and controlling VRE, decision makers may want to account for regional effects. Knowing a hospital's connections with other health care facilities via patient sharing can help determine which hospitals to include in a surveillance or control program. Copyright (C) 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
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