Modeling the regional spread and control of vancomycin-resistant enterococci.

TitleModeling the regional spread and control of vancomycin-resistant enterococci.
Publication TypeJournal Article
Year of Publication2013
AuthorsLee BY, S Yilmaz L, Wong KF, Bartsch SM, Eubank S, Song Y, Avery TR, Christie R, Brown ST, Epstein JM, Parker JI, Huang SS
JournalAm J Infect Control
Volume41
Issue8
Pagination668-73
Date Published2013 Aug
ISSN1527-3296
KeywordsAnti-Bacterial Agents, California, Computer Simulation, Cross Infection, Enterococcus, Gram-Positive Bacterial Infections, Hospitals, Humans, Infection Control, Prevalence, Vancomycin, Vancomycin Resistance
Abstract

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.

DOI10.1016/j.ajic.2013.01.013
Alternate JournalAm J Infect Control
PubMed ID23896284
PubMed Central IDPMC3836830
Grant List1U01 GM076672 / GM / NIGMS NIH HHS / United States
1U54GM088491-0109 / GM / NIGMS NIH HHS / United States
K23 AI064161 / AI / NIAID NIH HHS / United States
K23AI64161 / AI / NIAID 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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