Modeling the regional spread and control of vancomycin-resistant enterococci.

Modeling the regional spread and control of vancomycin-resistant enterococci.
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DOI:
10.1016/j.ajic.2013.01.013
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发表时间:
2013-08
影响因子:
4.9
通讯作者:
Huang SS
Huang SS
中科院分区:
医学3区
文献类型:
--
作者:
Lee BY;Yilmaz SL;Wong KF;Bartsch SM;Eubank S;Song Y;Avery TR;Christie R;Brown ST;Epstein JM;Parker JI;Huang SS

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由于患者可以长时间保持万古霉素耐药肠球菌(VRE)的定植,VRE可能从一个医疗机构传播到另一个医疗机构。使用区域医疗保健生态系统分析师,一个基于代理的模型,所有橙子县,加州州,医院和社区之间的患者流量,我们量化的程度和速度,在医院的VRE定植流行率的变化可能会影响其他橙子县医院的流行率。任何一家医院的VRE定植率持续增加10%,导致所有其他医院的VRE患病率平均相对增加2.8%(无至62%)。效果需要1.5至>10年才能完全显现。大医院往往对其他医院的影响更大。在监测和控制VRE时,决策者可能希望考虑到区域影响。通过患者共享了解医院与其他医疗机构的联系可以帮助确定哪些医院应纳入监测或控制计划。
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. 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. 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. 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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