Modeling the regional spread and control of vancomycin-resistant enterococci

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

Date Published: 2013-08

DOI: 10.1016/j.ajic.2013.01.013

Sponsors: Pennsylvania Department of Health United States National Institutes of Health (NIH)

Platforms: No platforms listed

Model Documentation: Other Narrative Flow charts

Model Code URLs: Model code not found

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. Copyright (C) 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Tags

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