efficacy of infection control interventions in reducing the spread of multidrug-resistant organisms in the hospital setting感染控制措施的效果在减少耐多药生物的传播在医院设置.pdfVIP

Efficacy of Infection Control Interventions in Reducing the Spread of Multidrug-Resistant Organisms in the Hospital Setting 1 2,3 4 2 5 Erika M. C. D’Agata *, Mary Ann Horn , Shigui Ruan , Glenn F. Webb , Joanna R. Wares 1 Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America, 2 Department of Mathematics, Vanderbilt University, Nashville, Tennessee, United States of America, 3 Division of Mathematical Sciences, National Science Foundation, Arlington, Virginia, United States of America, 4 Department of Mathematics, University of Miami, Coral Gables, Florida, United States of America, 5 Department of Math and Computer Science, University of Richmond, Richmond, Virginia, United States of America Abstract Multidrug-resistant organisms (MDRO) continue to spread in hospitals globally, but the population-level impact of recommended preventive strategies and the relative benefit of individual strategies targeting all MDRO in the hospital setting are unclear. To explore the dynamics of MDRO transmission in the hospital, we develop a model extending data from clinical individual-level studies to quantify the impact of hand hygiene, contact precautions, reducing antimicrobial exposure and screening surveillance cultures in decreasing the prevalence of MDRO colonization and infection. The effect of an ongoing increase in the influx of patients colonized with MDRO into the hospital setting is also quantified. We find that most recommended strategies have substantial effect in decreasing the prevalence of MDRO over time. However, screening for asymptomatic MDRO colonization among patients