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Modeling the regional spread and control of vancomycin-resistant enterococci.
- Author(s): Lee, Bruce Y;
- Yilmaz, S Levent;
- Wong, Kim F;
- Bartsch, Sarah M;
- Eubank, Stephen;
- Song, Yeohan;
- Avery, Taliser R;
- Christie, Richard;
- Brown, Shawn T;
- Epstein, Joshua M;
- Parker, Jon I;
- Huang, Susan S
- et al.
Published Web Locationhttps://doi.org/10.1016/j.ajic.2013.01.013
BackgroundBecause patients can remain colonized with vancomycin-resistant enterococci (VRE) for long periods of time, VRE may spread from one health care facility to another.
MethodsUsing 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.
ResultsA 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.
ConclusionsWhen 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.
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