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An individual-based model of transmission of resistant bacteria in a veterinary teaching hospital.

Suthar N, Roy S, Call DR, Besser TE, Davis MA - PLoS ONE (2014)

Bottom Line: The model was parameterized using data obtained from hospital records, information obtained by interviews with hospital staff, and the published literature.The model suggested that transmission resulting from contact with healthcare workers was common, and that certain transmission points (housing wards, diagnostics room, and the intensive care unit) presented higher risk for transmission than others (lobby and surgery).Sensitivity analyses using a range of parameter values demonstrated that the risk of acquisition of colonization by resistant pathogens decreased with shorter patient hospital stays (P<0.0001), more frequent decontamination of transmission points and disinfection of healthcare workers (P<0.0001) and better compliance of healthcare workers with hygiene practices (P<0.0001).

View Article: PubMed Central - PubMed

Affiliation: Paul G. Allen School for Global Animal Health, College of Veterinary Medicine, Washington State University, Pullman, Washington, United States of America.

ABSTRACT
Veterinary nosocomial infections caused by antibiotic resistant bacteria cause increased morbidity, higher cost and length of treatment and increased zoonotic risk because of the difficulty in treating them. In this study, an individual-based model was developed to investigate the effects of movements of canine patients among ten areas (transmission points) within a veterinary teaching hospital, and the effects of these movements on transmission of antibiotic susceptible and resistant pathogens. The model simulates contamination of transmission points, healthcare workers, and patients as well as the effects of decontamination of transmission points, disinfection of healthcare workers, and antibiotic treatments of canine patients. The model was parameterized using data obtained from hospital records, information obtained by interviews with hospital staff, and the published literature. The model suggested that transmission resulting from contact with healthcare workers was common, and that certain transmission points (housing wards, diagnostics room, and the intensive care unit) presented higher risk for transmission than others (lobby and surgery). Sensitivity analyses using a range of parameter values demonstrated that the risk of acquisition of colonization by resistant pathogens decreased with shorter patient hospital stays (P<0.0001), more frequent decontamination of transmission points and disinfection of healthcare workers (P<0.0001) and better compliance of healthcare workers with hygiene practices (P<0.0001). More frequent decontamination of heavily trafficked transmission points was especially effective at reducing transmission of the model pathogen.

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Distribution of strain types and colonization or infection status in the patient population.The fraction of patients in the hospital colonized, colonized with a resistant strain (R), colonized with a non-resistant strain (NR) and colonized with both resistant and non-resistant strains (R+NR), at the end of each day, averaged over 500 simulations.
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pone-0098589-g002: Distribution of strain types and colonization or infection status in the patient population.The fraction of patients in the hospital colonized, colonized with a resistant strain (R), colonized with a non-resistant strain (NR) and colonized with both resistant and non-resistant strains (R+NR), at the end of each day, averaged over 500 simulations.

Mentions: We start the simulation for a year with a clean and empty hospital and as inpatients accumulate, the mean population of patients inside the hospital at any time reaches a stable level. At the baseline values for all parameters, the fraction of the hospital patient population colonized with any strain stabilizes at approximately 32%. Approximately 30% of the patients are colonized with the non-resistant strain, 7% are colonized with the resistant strain, and 5% are colonized with both strains (Fig. 2).


An individual-based model of transmission of resistant bacteria in a veterinary teaching hospital.

Suthar N, Roy S, Call DR, Besser TE, Davis MA - PLoS ONE (2014)

Distribution of strain types and colonization or infection status in the patient population.The fraction of patients in the hospital colonized, colonized with a resistant strain (R), colonized with a non-resistant strain (NR) and colonized with both resistant and non-resistant strains (R+NR), at the end of each day, averaged over 500 simulations.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4043964&req=5

pone-0098589-g002: Distribution of strain types and colonization or infection status in the patient population.The fraction of patients in the hospital colonized, colonized with a resistant strain (R), colonized with a non-resistant strain (NR) and colonized with both resistant and non-resistant strains (R+NR), at the end of each day, averaged over 500 simulations.
Mentions: We start the simulation for a year with a clean and empty hospital and as inpatients accumulate, the mean population of patients inside the hospital at any time reaches a stable level. At the baseline values for all parameters, the fraction of the hospital patient population colonized with any strain stabilizes at approximately 32%. Approximately 30% of the patients are colonized with the non-resistant strain, 7% are colonized with the resistant strain, and 5% are colonized with both strains (Fig. 2).

Bottom Line: The model was parameterized using data obtained from hospital records, information obtained by interviews with hospital staff, and the published literature.The model suggested that transmission resulting from contact with healthcare workers was common, and that certain transmission points (housing wards, diagnostics room, and the intensive care unit) presented higher risk for transmission than others (lobby and surgery).Sensitivity analyses using a range of parameter values demonstrated that the risk of acquisition of colonization by resistant pathogens decreased with shorter patient hospital stays (P<0.0001), more frequent decontamination of transmission points and disinfection of healthcare workers (P<0.0001) and better compliance of healthcare workers with hygiene practices (P<0.0001).

View Article: PubMed Central - PubMed

Affiliation: Paul G. Allen School for Global Animal Health, College of Veterinary Medicine, Washington State University, Pullman, Washington, United States of America.

ABSTRACT
Veterinary nosocomial infections caused by antibiotic resistant bacteria cause increased morbidity, higher cost and length of treatment and increased zoonotic risk because of the difficulty in treating them. In this study, an individual-based model was developed to investigate the effects of movements of canine patients among ten areas (transmission points) within a veterinary teaching hospital, and the effects of these movements on transmission of antibiotic susceptible and resistant pathogens. The model simulates contamination of transmission points, healthcare workers, and patients as well as the effects of decontamination of transmission points, disinfection of healthcare workers, and antibiotic treatments of canine patients. The model was parameterized using data obtained from hospital records, information obtained by interviews with hospital staff, and the published literature. The model suggested that transmission resulting from contact with healthcare workers was common, and that certain transmission points (housing wards, diagnostics room, and the intensive care unit) presented higher risk for transmission than others (lobby and surgery). Sensitivity analyses using a range of parameter values demonstrated that the risk of acquisition of colonization by resistant pathogens decreased with shorter patient hospital stays (P<0.0001), more frequent decontamination of transmission points and disinfection of healthcare workers (P<0.0001) and better compliance of healthcare workers with hygiene practices (P<0.0001). More frequent decontamination of heavily trafficked transmission points was especially effective at reducing transmission of the model pathogen.

Show MeSH
Related in: MedlinePlus