BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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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Authors: Bruce Y Lee; Sarah M McGlone; Yeohan Song; Taliser R Avery; Stephen Eubank; Chung-Chou Chang; Rachel R Bailey; Diane K Wagener; Donald S Burke; Richard Platt; Susan S Huang Journal: Am J Public Health Date: 2011-02-17 Impact factor: 9.308
Authors: M A Montecalvo; H de Lencastre; M Carraher; C Gedris; M Chung; K VanHorn; G P Wormser Journal: Infect Control Hosp Epidemiol Date: 1995-12 Impact factor: 3.254
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Authors: Bruce Y Lee; Sarah M Bartsch; Kim F Wong; James A McKinnell; Rachel B Slayton; Loren G Miller; Chenghua Cao; Diane S Kim; Alexander J Kallen; John A Jernigan; Susan S Huang Journal: Am J Epidemiol Date: 2016-02-08 Impact factor: 4.897
Authors: Bruce Y Lee; Sarah M Bartsch; Kim F Wong; James A McKinnell; Eric Cui; Chenghua Cao; Diane S Kim; Loren G Miller; Susan S Huang Journal: Am J Epidemiol Date: 2016-02-11 Impact factor: 4.897
Authors: Anna Maria Niewiadomska; Bamini Jayabalasingham; Jessica C Seidman; Lander Willem; Bryan Grenfell; David Spiro; Cecile Viboud Journal: BMC Med Date: 2019-04-24 Impact factor: 8.775
Authors: Bruce Y Lee; Sarah M Bartsch; Michael Y Lin; Lindsey Asti; Joel Welling; Leslie E Mueller; Jim Leonard; Shawn T Brown; Kruti Doshi; Sarah K Kemble; Elizabeth A Mitgang; Robert A Weinstein; William E Trick; Mary K Hayden Journal: Am J Epidemiol Date: 2021-02-01 Impact factor: 4.897