Modeling Spread of KPC-Producing Bacteria in Long-Term Acute Care Hospitals in the Chicago Region, USA
| Autor: | Haverkate, Manon R, Bootsma, Martin C J, Weiner, Shayna, Blom, Donald, Lin, Michael Y, Lolans, Karen, Moore, Nicholas M, Lyles, Rosie D, Weinstein, Robert A, Bonten, Marc J M, Hayden, Mary K, Sub Mathematical Modeling, LS Infectiebiologie (Bacteriologie), Mathematical Modeling |
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| Přispěvatelé: | Sub Mathematical Modeling, LS Infectiebiologie (Bacteriologie), Mathematical Modeling |
| Rok vydání: | 2015 |
| Předmět: |
Male
Pediatrics Bathing Epidemiology OUTBREAK COLONIZATION law.invention 0302 clinical medicine law Acute care Prevalence polycyclic compounds Medicine 030212 general & internal medicine Non-U.S. Gov't Aged 80 and over Cross Infection 0303 health sciences Research Support Non-U.S. Gov't Enterobacteriaceae Infections RESISTANT STAPHYLOCOCCUS-AUREUS FACILITIES Middle Aged Hospitals Markov Chains 3. Good health CARBAPENEMASE-PRODUCING ENTEROBACTERIACEAE Infectious Diseases Transmission (mechanics) K. PNEUMONIAE Cohort Female KLEBSIELLA-PNEUMONIAE Monte Carlo Method Adult Microbiology (medical) medicine.medical_specialty TRANSMISSION Research Support Sensitivity and Specificity beta-Lactamases Article 03 medical and health sciences Enterobacteriaceae SURVEILLANCE Journal Article Humans Aged Chicago Models Statistical 030306 microbiology business.industry Outbreak biochemical phenomena metabolism and nutrition bacterial infections and mycoses Long-Term Care Long-term care Carriage business Biomarkers |
| Zdroj: | Infect Control Hosp Epidemiol Infection Control and Hospital Epidemiology, 36(10), 1148. Univ. of Chicago Press Infection control and hospital epidemiology, 36(10), 1148. University of Chicago Press |
| ISSN: | 1559-6834 0899-823X |
| Popis: | OBJECTIVEPrevalence ofblaKPC-encoding Enterobacteriaceae (KPC) in Chicago long-term acute care hospitals (LTACHs) rose rapidly after the first recognition in 2007. We studied the epidemiology and transmission capacity of KPC in LTACHs and the effect of patient cohorting.METHODSData were available from 4 Chicago LTACHs from June 2012 to June 2013 during a period of bundled interventions. These consisted of screening for KPC rectal carriage, daily chlorhexidine bathing, medical staff education, and 3 cohort strategies: a pure cohort (all KPC-positive patients on 1 floor), single rooms for KPC-positive patients, and a mixed cohort (all KPC-positive patients on 1 floor, supplemented with KPC-negative patients). A data-augmented Markov chain Monte Carlo (MCMC) method was used to model the transmission process.RESULTSAverage prevalence of KPC colonization was 29.3%. On admission, 18% of patients were colonized; the sensitivity of the screening process was 81%. The per admission reproduction number was 0.40. The number of acquisitions per 1,000 patient days was lowest in LTACHs with a pure cohort ward or single rooms for colonized patients compared with mixed-cohort wards, but 95% credible intervals overlapped.CONCLUSIONSPrevalence of KPC in LTACHs is high, primarily due to high admission prevalence and the resultant impact of high colonization pressure on cross transmission. In this setting, with an intervention in place, patient-to-patient transmission is insufficient to maintain endemicity. Inclusion of a pure cohort or single rooms for KPC-positive patients in an intervention bundle seemed to limit transmission compared to use of a mixed cohort.Infect Control Hosp Epidemiol2015;36(10):1148–1154 |
| Databáze: | OpenAIRE |
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