Transmission dynamic of methicillin-resistant Staphylococcus aureus in a medical intensive care unit

Autor: Ian P. Hall, S. Leach, Stéphane Hugonnet, Iain Barrass, Didier Pittet
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Psychological intervention
lcsh:Medicine
medicine.disease_cause
Biochemistry
Cohort Studies
Patient Isolation
Switzerland/epidemiology
Health care
Epidemiology
Prospective Studies
lcsh:Science
Research Articles
ddc:616
Cross Infection/epidemiology/microbiology/transmission
Cross Infection
Transmission dynamic
Transmission (medicine)
General Medicine
Staphylococcal Infections
Intensive Care Units
Intensive Care Units/statistics & numerical data
Oral Presentation
epidemiology
Switzerland
Biotechnology
Cohort study
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty
Isolation (health care)
Health Personnel
Biomedical Engineering
Biophysics
Staphylococcal Infections/epidemiology/microbiology/transmission
Bioengineering
Staphylococcal infections
Models
Biological
General Biochemistry
Genetics and Molecular Biology
Biomaterials
Intensive care
medicine
Methicillin-Resistant Staphylococcus aureus/growth & development
Humans
mathematical modelling
Intensive care medicine
Chi-Square Distribution
Models
Statistical
Relative efficacy
business.industry
lcsh:R
methicillin-resistant Staphyloccocus aureus
medicine.disease
Methicillin-resistant Staphylococcus aureus
Medical intensive care unit
lcsh:Q
business
Zdroj: BMC Proceedings, Vol 5, Iss Suppl 6, p O73 (2011)
BMC Proceedings
Journal of the Royal Society. Interface, Vol. 9, No 75 (2012) pp. 2639-52
Hall, I M, Barrass, I, Leach, S, Pittet, D & Hugonnet, S 2012, ' Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit ', Journal of the Royal Society Interface, vol. 9, no. 75, pp. 2639–2652 . https://doi.org/10.1098/rsif.2012.0134
ISSN: 1753-6561
1742-5689
DOI: 10.1098/rsif.2012.0134
Popis: Intensive care units (ICUs) play an important role in the epidemiology of methicillin-resistant Staphyloccocus aureus (MRSA). Although successful interventions are multi-modal, the relative efficacy of single measures remains unknown. We developed a discrete time, individual-based, stochastic mathematical model calibrated on cross-transmission observed through prospective surveillance to explore the transmission dynamics of MRSA in a medical ICU. Most input parameters were derived from locally acquired data. After fitting the model to the 46 observed cross-transmission events and performing sensitivity analysis, several screening and isolation policies were evaluated by simulating the number of cross-transmissions and isolation-days. The number of all cross-transmission events increased from 54 to 72 if only patients with a past history of MRSA colonization are screened and isolated at admission, to 75 if isolation is put in place only after the results of the admission screening become available, to 82 in the absence of admission screening and with a similar reactive isolation policy, and to 95 when no isolation policy is in place. The method used (culture or polymerase chain reaction) for admission screening had no impact on the number of cross-transmissions. Systematic regular screening during ICU stay provides no added-value, but aggressive admission screening and isolation effectively reduce the number of cross-transmissions. Critically, colonized healthcare workers may play an important role in MRSA transmission and their screening should be reinforced.
Databáze: OpenAIRE
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