Role of the hospital environment in disease transmission, with a focus on Clostridium difficile

Rutala, William A.; Weber, David J.

doi:10.1071/hi12057

Cited by 15 publications

(11 citation statements)

References 102 publications

(144 reference statements)

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“…These equilibria can be used as practical guidance to identify potential “high-risk” environment/hosts (i.e., having a relatively large value of equilibrium; for example, any environment and/or host having more than of total pathogen could be considered as “high-risk”, where represents homogeneous pathogen distribution across all hosts and environment). Empirical studies to identify “high-risk” fomites in healthcare facilities are generally based on contact structure of fomites (i.e., contact duration and frequency between host and fomite 9,10,12 ). Our findings from pathogens perspective could help develop more specific controlling strategies against HAI.…”

Section: Resultsmentioning

confidence: 99%

“…are transmitted partially or exclusively through contaminated environments 4–8 . Healthcare-associated infections (HAI, also known as nosocomial infections) are also facilitated by contacting surfaces and medical devices contaminated with pathogens, such as pathogenic Clostridium difficile 9,10 , Vancomycin-resistant Enterococci (VRE) 11,12 , and Methicillin-resistant Staphylococcus aureus (MRSA) 13,14 , and cause a tremendous amount of health and economic burden for society. Therefore, various novel modeling techniques have been developed and discussed to highlight the role of environment in infectious disease transmission especially HAIs 15–17 .…”

Section: Introductionmentioning

confidence: 99%

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Metapopulation Model from Pathogen’s Perspective: A Versatile Framework to Quantify Pathogen Transfer and Circulation between Environment and Hosts

Shi

Lanzas

Lee

et al. 2019

Sci Rep

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Metapopulation models have been primarily explored in infectious disease epidemiology to study host subpopulation movements and between-host contact structures. They also have the potential to investigate environmental pathogen transferring. In this study, we demonstrate that metapopulation models serve as an ideal modeling framework to characterize and quantify pathogen transfer between environment and hosts. It therefore unifies host, pathogen, and environment, collectively known as the epidemiological triad, a fundamental concept in epidemiology. We develop a customizable and generalized pathogen-transferring model where pathogens dwell in and transferring (via contact) between environment and hosts. We analyze three specific case studies: pure pathogen transferring without pathogen demography, source-sink dynamics, and pathogen control via external disinfection. We demonstrate how pathogens circulate in the system between environment and hosts, as well as evaluate different controlling efforts for healthcare-associated infections (HAIs). For pure pathogen transferring, system equilibria can be derived analytically to explicitly quantify long-term pathogen distribution in the system. For source-sink dynamics and pathogen control via disinfection, we demonstrate that complete eradication of pathogens can be achieved, but the rates of converging to system equilibria differ based on specific model parameterization. Direct host-host pathogen transferring and within-host dynamics can be future directions of this modeling framework by adding specific modules.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metapopulation Model from Pathogen’s Perspective: A Versatile Framework to Quantify Pathogen Transfer and Circulation between Environment and Hosts

Shi

Lanzas

Lee

et al. 2019

Sci Rep

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“…A nosocomialis patogének fő forrása a beteg endogén fl órája, azonban az egészség-ügyi ellátással összefüggő fertőzéseket kiváltó mikroorganizmusok átvitele leggyakrabban a kezeken, kontakt módon történik. A kontakt átvitel során a nem megfelelő módon elvégzett kézhigiéné után az egészségügyi dolgozó egy másik személyt vagy felületet (például mobil kommunikációs eszköz) megérintve terjeszti tovább a kórokozót (például methicillinrezisztens Staphylococcus aureus, Acinetobacter sp., Candida sp., rhinovírus, norovírus, hepatitis A-vírus) légúti, emésztőszervi, húgyúti, illetve bőr-és lágyrész-fertőzéseket okozva [3,4].…”

Section: öSszefoglaló Közleményunclassified

A mobil kommunikációs eszközök szerepe a fertőzések átvitelében. Szisztematikus irodalomelemzés

Morvai

Szabó

2015

Orvosi Hetilap

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Napjainkra a mobil kommunikációs eszközök a kommunikáció elengedhetetlen kellékeivé váltak a kórházakban a számtalan alkalmazási lehetőségnek köszönhetően (például diagnózis, oktatás), azonban potenciálisan kontaminálód-hatnak különböző kórokozókkal. A szerzők célja, hogy áttekintsék a mobil kommunikációs eszközök szerepét a kórokozók terjesztésében, és ismertessék a hatékony megelőzési stratégiákat. Részletes szisztematikus irodalomkeresést végeztek a PubMed és a ScienceDirect adatbázisokban 2004. január és 2014. augusztus között. Kizárólag angol nyelvű és teljes terjedelmükben elérhető cikkeket kerestek, amihez megfelelő kulcsszavakat használtak. Potenciálisan relevánsnak 216 közlemény tűnt, amelyből 30 felelt meg a beválasztási kritériumoknak. Ezek alapján az egészségügyi dolgozók 8%-a fertőtleníti rendszeresen a mobil kommunikációs eszközeit, amelyek 40-100%-ban kontaminálódtak patogénekkel. Az egészségügyi dolgozók mobil kommunikációs eszközeiről legnagyobb számban kitenyészett kór-okozó a koaguláznegatív Staphylococcus és a Staphylococcus aureus volt, amelyek nagy része (10-95,3%) methicillinrezisztens volt. Az oktatás, a kézhigiéné és a mobil kommunikációs eszközök rendszeres fertőtlenítése a bakteriális kontamináció csökkentésének hatékony módszere. Orv. Hetil., 2015, 156(20), 802-807.

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“…[7][8][9] Several studies have demonstrated that the persistence of microorganisms in the environment leads to an increased risk of acquiring an infection for a patient who is admitted to a room that was previously occupied by a patient colonised or infected with a particular organism. 8,10,11 These studies, alongside those on the known role of colonisation pressure, demonstrate the potentially important role that the environment plays in infection transmission and prevention.…”

Section: Introductionmentioning

confidence: 96%

Prior room occupancy increases risk of methicillin-resistant Staphylococcus aureus acquisition

Mitchell

Digney

Ferguson

2014

Healthcare infection

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Background: In Australia, little is known about the risk of acquiring methicillin-resistant Staphylococcus aureus (MRSA) from prior room occupants. The aims of the study are to understand the risk of MRSA acquisition from prior room occupants and to further extend the existing knowledge-base on the role of discharge cleaning in hospitals. Methods: A non-concurrent cohort study was undertaken in five wards at a 250-bed general hospital in Tasmania, Australia. All admitted patients were screened for MRSA. Weekly screenings for all patients who remained in hospital were undertaken. New MRSA acquisitions were identified. The exposed group were patients whose immediate prior room occupant had MRSA, while the unexposed prior room occupant did not have MRSA. Results: 6228 patients were at risk of acquiring MRSA, with 237 new MRSA acquisitions equating to an acquisition rate of 3.8% for each at-risk patient admission. The unadjusted odds ratio for acquiring MRSA when the prior room occupant had MRSA was 2.9 (95% CI 2.2-3.9). Using logistic regression, exposure to a prior occupant harbouring MRSA remained a significant predictor of subsequent acquisition, after controlling for variables, OR 2.7 (95% CI 2.0-3.6). Conclusion: Admission to a room previously occupied by a person with MRSA increased the odds of acquisition for the subsequent patient, independent of other risk factors. It demonstrates the necessity of having effective discharge cleaning practices in place. We believe increased attention to discharge room cleaning in hospitals is required and the reconsideration of additional recommendations for discharge cleaning.

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Role of the hospital environment in disease transmission, with a focus on Clostridium difficile

Cited by 15 publications

References 102 publications

Metapopulation Model from Pathogen’s Perspective: A Versatile Framework to Quantify Pathogen Transfer and Circulation between Environment and Hosts

Metapopulation Model from Pathogen’s Perspective: A Versatile Framework to Quantify Pathogen Transfer and Circulation between Environment and Hosts

A mobil kommunikációs eszközök szerepe a fertőzések átvitelében. Szisztematikus irodalomelemzés

Prior room occupancy increases risk of methicillin-resistant Staphylococcus aureus acquisition

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