CoMSES Catalog

Evaluating Infection Prevention Strategies in Out-Patient Dialysis Units Using Agent-Based Modeling

Authored by Joanna R Wares, Barry Lawson, Douglas Shemin, Erika M C D'Agata

Date Published: 2016

DOI: 10.1371/journal.pone.0153820

Sponsors: Agency of Healthcare Research and Quality

Platforms: MATLAB

Model Documentation: Other Narrative

Model Code URLs: Model code not found

Abstract

Patients receiving chronic hemodialysis (CHD) are among the most vulnerable to infections caused by multidrug-resistant organisms (MDRO), which are associated with high rates of morbidity and mortality. Current guidelines to reduce transmission of MDRO in the outpatient dialysis unit are targeted at patients considered to be high-risk for transmitting these organisms: those with infected skin wounds not contained by a dressing, or those with fecal incontinence or uncontrolled diarrhea. Here, we hypothesize that targeting patients receiving antimicrobial treatment would more effectively reduce transmission and acquisition of MDRO. We also hypothesize that environmental contamination plays a role in the dissemination of MDRO in the dialysis unit. To address our hypotheses, we built an agent-based model to simulate different treatment strategies in a dialysis unit. Our results suggest that reducing antimicrobial treatment, either by reducing the number of patients receiving treatment or by reducing the duration of the treatment, markedly reduces overall colonization rates and also the levels of environmental contamination in the dialysis unit. Our results also suggest that improving the environmental decontamination efficacy between patient dialysis treatments is an effective method for reducing colonization and contamination rates. These findings have important implications for the development and implementation of future infection prevention strategies.

Evaluating Infection Prevention Strategies in Out-Patient Dialysis Units Using Agent-Based Modeling

Abstract

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