Modeling the regional spread and control of vancomycin-resistant enterococci

Bruce Y. Lee; S. Levent Yilmaz; Kim F. Wong; Sarah M. Bartsch; Stephen Eubank; Yeohan Song; Taliser R. Avery; Richard Christie; Shawn T. Brown; Joshua M. Epstein; Jon I. Parker; Susan S. Huang

doi:10.1016/j.ajic.2013.01.013

Modeling the regional spread and control of vancomycin-resistant enterococci

Bruce Y. Lee, S. Levent Yilmaz, Kim F. Wong, Sarah M. Bartsch, Stephen Eubank, Yeohan Song, Taliser R. Avery, Richard Christie, Shawn T. Brown, Joshua M. Epstein, Jon I. Parker, Susan S. Huang

Global Public Health

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Because patients can remain colonized with vancomycin-resistant enterococci (VRE) for long periods of time, VRE may spread from one health care facility to another. Methods: Using 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. Results: A 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. Conclusions: When 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.

Original language	English (US)
Pages (from-to)	668-673
Number of pages	6
Journal	American Journal of Infection Control
Volume	41
Issue number	8
DOIs	https://doi.org/10.1016/j.ajic.2013.01.013
State	Published - Aug 2013

Keywords

Health care-associated infections
Hospitals
Modeling
Simulation
Vancomycin-resistant Enterococcus

ASJC Scopus subject areas

Epidemiology
Health Policy
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1016/j.ajic.2013.01.013

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title = "Modeling the regional spread and control of vancomycin-resistant enterococci",

abstract = "Background: Because patients can remain colonized with vancomycin-resistant enterococci (VRE) for long periods of time, VRE may spread from one health care facility to another. Methods: Using 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. Results: A 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. Conclusions: When 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.",

keywords = "Health care-associated infections, Hospitals, Modeling, Simulation, Vancomycin-resistant Enterococcus",

author = "Lee, {Bruce Y.} and Yilmaz, {S. Levent} and Wong, {Kim F.} and Bartsch, {Sarah M.} and Stephen Eubank and Yeohan Song and Avery, {Taliser R.} and Richard Christie and Brown, {Shawn T.} and Epstein, {Joshua M.} and Parker, {Jon I.} and Huang, {Susan S.}",

note = "Funding Information: This study was supported by the National Institute of General Medical Sciences Models of Infectious Disease Agent Study grants 1U54GM088491-0109 and 1U01 GM076672 , as well as National Institutes of Health grant No. K23AI64161 and the Pennsylvania Department of Health . The funders had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; nor the preparation, review, or approval of the manuscript. ",

year = "2013",

month = aug,

doi = "10.1016/j.ajic.2013.01.013",

language = "English (US)",

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pages = "668--673",

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AU - Lee, Bruce Y.

AU - Yilmaz, S. Levent

AU - Wong, Kim F.

AU - Bartsch, Sarah M.

AU - Eubank, Stephen

AU - Song, Yeohan

AU - Avery, Taliser R.

AU - Christie, Richard

AU - Brown, Shawn T.

AU - Epstein, Joshua M.

AU - Parker, Jon I.

AU - Huang, Susan S.

N1 - Funding Information: This study was supported by the National Institute of General Medical Sciences Models of Infectious Disease Agent Study grants 1U54GM088491-0109 and 1U01 GM076672 , as well as National Institutes of Health grant No. K23AI64161 and the Pennsylvania Department of Health . The funders had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; nor the preparation, review, or approval of the manuscript.

PY - 2013/8

Y1 - 2013/8

N2 - Background: Because patients can remain colonized with vancomycin-resistant enterococci (VRE) for long periods of time, VRE may spread from one health care facility to another. Methods: Using 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. Results: A 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. Conclusions: When 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.

AB - Background: Because patients can remain colonized with vancomycin-resistant enterococci (VRE) for long periods of time, VRE may spread from one health care facility to another. Methods: Using 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. Results: A 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. Conclusions: When 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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KW - Hospitals

KW - Modeling

KW - Simulation

KW - Vancomycin-resistant Enterococcus

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Modeling the regional spread and control of vancomycin-resistant enterococci

Abstract

Keywords

ASJC Scopus subject areas

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