Modeling the spread of methicillin-resistant Staphylococcus aureus (MRSA) outbreaks throughout the hospitals in Orange County, California.

TitleModeling the spread of methicillin-resistant Staphylococcus aureus (MRSA) outbreaks throughout the hospitals in Orange County, California.
Publication TypeJournal Article
Year of Publication2011
AuthorsLee BY, McGlone SM, Wong KF, S Yilmaz L, Avery TR, Song Y, Christie R, Eubank S, Brown ST, Epstein JM, Parker JI, Burke DS, Platt R, Huang SS
JournalInfect Control Hosp Epidemiol
Volume32
Issue6
Pagination562-72
Date Published2011 Jun
ISSN1559-6834
KeywordsCalifornia, Computer Simulation, Cross Infection, Disease Outbreaks, Epidemiologic Methods, Humans, Length of Stay, Methicillin-Resistant Staphylococcus aureus, Patient Readmission, Patient Transfer, Prevalence, Staphylococcal Infections, Time Factors
Abstract

BACKGROUND: Since hospitals in a region often share patients, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in one hospital could affect other hospitals.METHODS: Using extensive data collected from Orange County (OC), California, we developed a detailed agent-based model to represent patient movement among all OC hospitals. Experiments simulated MRSA outbreaks in various wards, institutions, and regions. Sensitivity analysis varied lengths of stay, intraward transmission coefficients (β), MRSA loss rate, probability of patient transfer or readmission, and time to readmission.RESULTS: Each simulated outbreak eventually affected all of the hospitals in the network, with effects depending on the outbreak size and location. Increasing MRSA prevalence at a single hospital (from 5% to 15%) resulted in a 2.9% average increase in relative prevalence at all other hospitals (ranging from no effect to 46.4%). Single-hospital intensive care unit outbreaks (modeled increase from 5% to 15%) caused a 1.4% average relative increase in all other OC hospitals (ranging from no effect to 12.7%).CONCLUSION: MRSA outbreaks may rarely be confined to a single hospital but instead may affect all of the hospitals in a region. This suggests that prevention and control strategies and policies should account for the interconnectedness of health care facilities.

DOI10.1086/660014
Alternate JournalInfect Control Hosp Epidemiol
PubMed ID21558768
PubMed Central IDPMC3388111
Grant List1U01 GM076672 / GM / NIGMS NIH HHS / United States
1U54GM088491-0109 / GM / NIGMS NIH HHS / United States
U01 GM070694 / GM / NIGMS NIH HHS / United States
U01 GM076672 / GM / NIGMS NIH HHS / United States
U54 GM088491 / GM / NIGMS NIH HHS / United States
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