Effect of Patterns of Transferring Patients among Healthcare Institutions on Rates of Nosocomial Methicillin-Resistant Staphylococcus aureus Transmission: A Monte Carlo Simulation
Effect of Patterns of Transferring Patients among Healthcare Institutions on Rates of Nosocomial Methicillin-Resistant Staphylococcus aureus Transmission: A Monte Carlo Simulation
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DOI：
10.1086/657945
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发表时间：
2011-02-01
影响因子：
4.5
通讯作者：
Raboud, Janet
中科院分区：
文献类型：
--
作者：
Lesosky, Maia;McGeer, Allison;Raboud, Janet
目标。为确定单一都市区域内机构间病人转移率和模式对医院和疗养院病人之间的耐甲氧西林金黄色葡萄球菌(MRSA)传播率的影响。方法：采用随机、离散时间的蒙特卡罗模拟方法模拟单个都市区域内医疗机构中MRSA的传播率和传播率。针对不同的机构间转移策略和不同的情景场景，如传播率较高的异常点机构，模拟了医院的入院、出院、转移和医院内传播。结果模拟结果表明，转移模式和传输率的变化不影响MRSA在医院内的传播。传播率高的离群点机构对全系统医院感染率的影响因机构类型不同而不同。结论：了解疾病传播动力学和机构间转移模式对于管理新近引入的疾病或菌株是值得努力的。一旦在一个系统中流行，就需要实施其他传播控制战略。感染控制猪瘟2011；32(2)：136-147
OBJECTIVE. To determine the effect of the rate and pattern of patient transfers among institutions within a single metropolitan area on the rates of methicillin-resistant Staphylococcus aureus (MRSA) transmission among patients in hospitals and nursing homes.METHODS. A stochastic, discrete-time, Monte Carlo simulation was used to model the rate and spread of MRSA transmission among patients in medical institutions within a single metropolitan area. Admission, discharges, transfers, and nosocomial transmission were simulated with respect to different interinstitutional transfer strategies and various situational scenarios, such as outlier institutions with high transmission rates.RESULTS. The simulation results indicated that transfer patterns and transfer rate changes do not affect nosocomial MRSA transmission. Outlier institutions with high transmission rates affect the systemwide rate of nosocomial infections differently, depending on institution type.CONCLUSION. It is worth effort to understanding disease-transmission dynamics and interinstitutional transfer patterns for the management of recently introduced diseases or strains. Once endemic in a system, other strategies for transmission control need to be implemented. Infect Control Hosp Epidemiol 2011; 32(2):136-147