A unified stochastic modelling framework for the spread of nosocomial infections.
A unified stochastic modelling framework for the spread of nosocomial infections.
复制标题
DOI：
10.1098/rsif.2018.0060
复制
发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Kypraios T
中科院分区：
文献类型：
--
作者：
López-García M;Kypraios T
在过去的几年里，人们提出了许多随机模型来分析医院环境中医院感染的传播。这些模型通常考虑了控制传播动态的许多因素：患者自发定植、患者与工作人员污染/定植、环境污染、患者分组或医护人员 (HCW) 洗手合规水平。对于每个模型，都采用量身定制的方法来分析医院暴发的动态，通常通过研究感兴趣的数量，例如医院病房中每种病原体的繁殖数量，通常通过随机模拟或确定性近似来计算。在这项工作中，我们提出了一种高度通用的随机建模框架，可以同时考虑所有这些因素，并且允许人们在医院内爆发期间准确分析医院病房中每种病原体的繁殖数量。通过五个代表性案例研究，我们展示了这个统一的建模框架如何将文献中的许多现有模型理解为特定案例。我们开展了各种数值研究，通过这些研究，我们 (i) 强调医护人员保持高手部卫生合规水平的重要性，(ii) 支持感染控制策略，包括在疫情爆发期间改善环境清洁，以及 (iii) 展示一些医护人员在医院内疫情期间充当超级传播者的潜力。
Over the last years, a number of stochastic models have been proposed for analysing the spread of nosocomial infections in hospital settings. These models often account for a number of factors governing the spread dynamics: spontaneous patient colonization, patient–staff contamination/colonization, environmental contamination, patient cohorting or healthcare workers (HCWs) hand-washing compliance levels. For each model, tailor-designed methods are implemented in order to analyse the dynamics of the nosocomial outbreak, usually by means of studying quantities of interest such as the reproduction number of each agent in the hospital ward, which is usually computed by means of stochastic simulations or deterministic approximations. In this work, we propose a highly versatile stochastic modelling framework that can account for all these factors simultaneously, and which allows one to exactly analyse the reproduction number of each agent at the hospital ward during a nosocomial outbreak. By means of five representative case studies, we show how this unified modelling framework comprehends, as particular cases, many of the existing models in the literature. We implement various numerical studies via which we (i) highlight the importance of maintaining high hand-hygiene compliance levels by HCWs, (ii) support infection control strategies including to improve environmental cleaning during an outbreak and (iii) show the potential of some HCWs to act as super-spreaders during nosocomial outbreaks.
登录
查看更多内容
影响因子：
3.9
作者：
Noakes, Catherine J.;Sleigh, P. Andrew
通讯作者：
Sleigh, P. Andrew
DOI：
10.1073/pnas.0900974106
发表时间：
2009-10-27
影响因子：
11.1
作者：
Temime, Laura;Opatowski, Lulla;Guillemot, Didier
通讯作者：
Guillemot, Didier
影响因子：
3.6
作者：
Fackrell, Mark
通讯作者：
Fackrell, Mark
影响因子：
4.3
作者：
Trapman, Pieter;Bootsma, Martinus Christoffel Jozef
通讯作者：
Bootsma, Martinus Christoffel Jozef
影响因子：
2
作者：
Ross, J. V.
通讯作者：
Ross, J. V.