The Role of Healthcare Worker-Mediated Contact Networks in the Transmission of Vancomycin-Resistant Enterococci
The Role of Healthcare Worker-Mediated Contact Networks in the Transmission of Vancomycin-Resistant Enterococci
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DOI：
10.1093/ofid/ofaa056
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发表时间：
2020-03-01
影响因子：
4.2
通讯作者：
Milstone, Aaron M.
中科院分区：
文献类型：
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作者：
Klein, Eili Y.;Tseng, Katie K.;Milstone, Aaron M.
背景来自医院电子健康记录（EHR）的用户和时间戳数据提供了评估医护人员（HCW）介导的接触网络如何影响多重耐药病原体（如万古霉素耐药肠球菌（VRE））传播的机会。这是对2016年7月1日至2018年6月30日期间VRE事件采集的回顾性分析。从医院EHR系统中提取临床和人口统计学患者数据，包括所有记录的HCW与患者的接触。HCW在1小时内与2名不同患者接触被视为“联系”。通过在阴性监测培养后>= 72小时收集的阳性临床或监测培养来确定VRE获得事件。2364例患者有2952次住院，其中≥ 2个VRE监测拭子，112例（4.7%）患者有意外医院获得。患者每天记录的HCW接触的中位数为24次（四分位距[IQR]，18-33），其中9次（IQR，5-16）或约40%是发生的连接
Background. User- and time-stamped data from hospital electronic health records (EHRs) present opportunities to evaluate how healthcare worker (HCW)-mediated contact networks impact transmission of multidrug-resistant pathogens, such as vancomycin-resistant enterococci (VRE).Methods. This is a retrospective analysis of incident acquisitions of VRE between July 1, 2016 and June 30, 2018. Clinical and demographic patient data were extracted from the hospital EHR system, including all recorded HCW contacts with patients. Contacts by an HCW with 2 different patients within 1 hour was considered a "connection". Incident VRE acquisition was determined by positive clinical or surveillance cultures collected >= 72 hours after a negative surveillance culture.Results. There were 2952 hospitalizations by 2364 patients who had >= 2 VRE surveillance swabs, 112 (4.7%) patients of which had incident nosocomial acquisitions. Patients had a median of 24 (interquartile range [IQR], 18-33) recorded HCW contacts per day, 9 (IQR, 5-16) of which, or approximately 40%, were connections that occurred