Variation and trends in transmission dynamics of Methicillin-resistant Staphylococcus aureus in veterans affairs hospitals and nursing homes.
Epidemics
; 28: 100347, 2019 09.
Article
in En
| MEDLINE
| ID: mdl-31171468
ABSTRACT
Variation and differences of MRSA transmission within and between healthcare settings are not well understood. This variability is critical for understanding the potential impact of infection control interventions and could aid in the evaluation of future intervention strategies. We fit a Bayesian transmission model to detailed individual-level MRSA surveillance data from over 230 Veterans Affairs (VA) hospitals and nursing homes. Our approach disentangles the effects of potential confounders, including length of stay, admission prevalence, and clearance, estimating dynamic transmission model parameters and temporal trends. The median baseline transmission rate in hospitals was approximately four-fold higher than in nursing homes, and declined in 46% of hospitals and 9% of nursing homes, resulting in a median transmission rate reduction of 43% across hospitals and an increase of 2% in nursing homes. For first admissions into an acute care facility, the median (range) importation probability was 10.5% (5.9%-18.4%), and was nearly twice as large, 18.7% (9.2%-37.4%), in nursing homes. This analysis found differences within and between hospitals and nursing homes. The transmission rate declined substantially in hospitals and remained stable in nursing homes, while admission prevalence was considerably higher in nursing homes than in hospitals.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Staphylococcal Infections
/
Veterans
/
Methicillin-Resistant Staphylococcus aureus
/
Hospitals, Veterans
/
Nursing Homes
Type of study:
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Epidemics
Year:
2019
Document type:
Article