Hospital networks and the dispersal of hospital-acquired pathogens by patient transfer.
Hospital networks and the dispersal of hospital-acquired pathogens by patient transfer.
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DOI：
10.1371/journal.pone.0035002
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Grundmann H
中科院分区：
文献类型：
--
作者：
Donker T;Wallinga J;Slack R;Grundmann H
医院获得性感染（HAI）通常被视为可预防的事件，由不安全的做法或不良的医院卫生造成。然而，这忽略了一个事实，即传播性不仅是致病生物体的一种特性，而且也是宿主在医院之间移动时可以转移细菌的特性。从流行病学的意义上讲，医院通过他们共同的病人而联系在一起。我们在这里假设，医院的连通性程度对医院获得性细菌引起的感染率有着至关重要的影响。为了验证这一假设，我们根据UK-NHS医院事件统计数据绘制了患者的移动图，并观察到最近在另一家医院发生事件后入院的患者比例与强制性报告记录的MRSA菌血症的医院特异性发病率相关。我们观察到医院连通性与MRSA菌血症发病率之间的正相关性，自2001年以来，除2008-09年外的所有财政年度都具有显著性。所有年份合并后，这种相关性为正，与零有显著差异（偏相关系数r = 0.33（0.28至0.38））。 当比较英国医院的转诊模式与在荷兰观察到的转诊模式时，我们预测英国医院更有可能看到HAI的更快和更持续的传播。我们的研究结果表明，医院不能被视为单独的单位，而是应该被视为更大的模块化网络的连接元素。我们的研究结果强调了合作效应的重要性，这将对卫生保健系统的规划，病人管理和医院感染控制产生影响。
Hospital-acquired infections (HAI) are often seen as preventable incidents that result from unsafe practices or poor hospital hygiene. This however ignores the fact that transmissibility is not only a property of the causative organisms but also of the hosts who can translocate bacteria when moving between hospitals. In an epidemiological sense, hospitals become connected through the patients they share. We here postulate that the degree of hospital connectedness crucially influences the rates of infections caused by hospital-acquired bacteria. To test this hypothesis, we mapped the movement of patients based on the UK-NHS Hospital Episode Statistics and observed that the proportion of patients admitted to a hospital after a recent episode in another hospital correlates with the hospital-specific incidence rate of MRSA bacteraemia as recorded by mandatory reporting. We observed a positive correlation between hospital connectedness and MRSA bacteraemia incidence rate that is significant for all financial years since 2001 except for 2008–09. All years combined, this correlation is positive and significantly different from zero (partial correlation coefficient r = 0.33 (0.28 to 0.38)). When comparing the referral pattern for English hospitals with referral patterns observed in the Netherlands, we predict that English hospitals more likely see a swifter and more sustained spread of HAIs. Our results indicate that hospitals cannot be viewed as individual units but rather should be viewed as connected elements of larger modular networks. Our findings stress the importance of cooperative effects that will have a bearing on the planning of health care systems, patient management and hospital infection control.
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影响因子：
4.3
作者：
Salathé M;Jones JH
通讯作者：
Jones JH
影响因子：
3.7
作者：
Hao D;Li C
通讯作者：
Li C
影响因子：
64.8
作者：
Albert, R;Jeong, H;Barabási, AL
通讯作者：
Barabási, AL
DOI：
10.1073/pnas.122108599
发表时间：
2002-05-28
影响因子：
11.1
作者：
Enright, MC;Robinson, DA;Spratt, BG
通讯作者：
Spratt, BG
影响因子：
56.9
作者：
Ravasz, E;Somera, AL;Barabási, AL
通讯作者：
Barabási, AL