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‘Domino Effect’ Spreads Superbug Among Regional Hospitals

Authors see need for inter-hospital collaboration (July 30)

A moderate increase in vancomycin-resistant enterococci (VRE) at one hospital can lead to a nearly 3% increase in VRE in every other hospital in that county, according to a study in the August issue of the American Journal of Infection Control.

VRE is one of the most common bacteria that cause infections in health care facilities.

Researchers created a mathematical and computational model to track the movement between hospitals of VRE-colonized patients (patients carrying the organism but not yet infected) over the course of 1 year in Orange County, California. Using this model, they were able to assess how increases or decreases in one hospital’s VRE affected neighboring hospitals.

Not only did the investigators find that a moderate increase in VRE infections at any one hospital caused an average 2.8% increase throughout the county (range: 0% to 61%), they also discovered that hospitals in the most populated area of the county had an even greater likelihood of spreading VRE throughout the network.

Additional modeling identified a potential for “free-riders” — hospitals that will experience decreases in the incidence of VRE infections as a result of other hospitals’ infection-control efforts without initiating infection-prevention measures of their own.

The study points to the underutilization of patient-sharing data between regional hospitals; the importance of inter-hospital communication and collaboration in decreasing VRE infection rates; and the scope of variables that must be considered in analyzing the outcome of infection-prevention initiatives.

VRE can live in the human intestines and female genital tract without causing disease. Sometimes, however, the bugs can cause infections of the urinary tract, the bloodstream, or wounds associated with catheters or surgery. An estimated 20,000 to 85,000 cases of VRE infection occur each year in U.S. hospitals.

Source: AJIC; August 2013.

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