The impact of persistent gastrointestinal colonization on the transmission dynamics of vancomycin-resistant enterococci
The impact of persistent gastrointestinal colonization on the transmission dynamics of vancomycin-resistant enterococci
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DOI：
10.1086/339293
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发表时间：
2002-03-15
影响因子：
6.4
通讯作者：
Webb, GF
中科院分区：
文献类型：
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作者：
D'Agata, EMC;Horn, MA;Webb, GF
耐万古霉素肠球菌 (VRE) 的传播动力学及其传播因素非常复杂。使用数学模型来模拟患者和医护人员 (HCW) 之间的传播模式，并量化特定因素和感染控制干预措施对长期血液透析病房中 VRE 流行率 (EP) 的影响。该模型预测：(1) 随着时间的推移，无论最初定植的患者数量如何，EP 都将达到 12%；(2) 出院后新定植患者的不断涌入将维持地方性流行；(3) VRE 胃肠道定植持续时间对继发病例数量影响最大，使 EP 最多增加到 70%；(4) 降低患者与医护人员的比例或改善手部卫生将使 EP 降低至 3%。缩短定植持续时间、限制医院获得 VRE 以及提高血液透析室手部卫生的依从性可能会降低患者群体中 VRE 发生率的快速上升。
The transmission dynamics of vancomycin-resistant enterococci (VRE) and factors contributing to their dissemination are complex. Mathematical modeling was used to simulate patterns of dissemination among patients and health care workers (HCWs) and to quantify the contribution of specific factors and infection control interventions on the endemic prevalence (EP) of VRE in a long-term hemodialysis unit. The model predicted that (1) an EP of 12% would be reached over time, regardless of the number of patients initially colonized, (2) endemicity would be sustained by the constant influx of newly colonized patients discharged from the hospital, (3) duration of VRE gastrointestinal colonization would have the most impact on the number of secondary cases, increasing the EP to a maximum of 70%, and (4) decreasing the patient: HCW ratio or improving hand hygiene would decrease the EP to 3%. Decreasing the duration of colonization, limiting hospital acquisition of VRE, and improving compliance with hand hygiene in the hemodialysis unit may decrease the rapidly rising rates of VRE in the patient population.