Limits...
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.

Show MeSH

Related in: MedlinePlus

The yearly average of fraction of time that the transmission points remain contaminated.The yearly average of fraction of time each transmission point remains contaminated, averaged further over 500 simulations. Bars represent standard deviation across the yearly averages of 500 simulations.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4043964&req=5

pone-0098589-g005: The yearly average of fraction of time that the transmission points remain contaminated.The yearly average of fraction of time each transmission point remains contaminated, averaged further over 500 simulations. Bars represent standard deviation across the yearly averages of 500 simulations.

Mentions: Patient visits in the housing wards and the ICU area lead to colonization of the largest proportions of patients by the non-resistant strain. This proportion is significantly higher for housing than for all other transmission points except the ICU. The proportion of patients colonized by the resistant strain is highest for patients visiting the housing area or the recovery room. This proportion is significantly higher for housing, the ICU and diagnostics than for the surgery, exam rooms, lobby, radiology, and outside dog-walking areas (Fig. 4). The average fraction of time these places remain contaminated is also significantly higher amongst all the transmission points considered in the model, with diagnostics remaining contaminated for 31.2% (SD: 21.2%) of the time, ICU for 45.8% (SD: 27.4%) of the time and the housing wards for 56.9% (SD: 33.1%) of the time (Fig. 5).


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)

The yearly average of fraction of time that the transmission points remain contaminated.The yearly average of fraction of time each transmission point remains contaminated, averaged further over 500 simulations. Bars represent standard deviation across the yearly averages of 500 simulations.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0098589-g005: The yearly average of fraction of time that the transmission points remain contaminated.The yearly average of fraction of time each transmission point remains contaminated, averaged further over 500 simulations. Bars represent standard deviation across the yearly averages of 500 simulations.
Mentions: Patient visits in the housing wards and the ICU area lead to colonization of the largest proportions of patients by the non-resistant strain. This proportion is significantly higher for housing than for all other transmission points except the ICU. The proportion of patients colonized by the resistant strain is highest for patients visiting the housing area or the recovery room. This proportion is significantly higher for housing, the ICU and diagnostics than for the surgery, exam rooms, lobby, radiology, and outside dog-walking areas (Fig. 4). The average fraction of time these places remain contaminated is also significantly higher amongst all the transmission points considered in the model, with diagnostics remaining contaminated for 31.2% (SD: 21.2%) of the time, ICU for 45.8% (SD: 27.4%) of the time and the housing wards for 56.9% (SD: 33.1%) of the time (Fig. 5).

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