title: Efficacy of infection control interventions in reducing the spread of multidrug-resistant organisms in the hospital setting.
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 who are not receiving antimicrobials is of minimal value in reducing the spread of MDRO.
authors.affiliation: Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America. edagata@bidmc.harvard.edu
authors.forename: Erika M C
authors.initials: EM
authors.lastname: D'Agata
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Horn
authors.forename: Shigui
authors.initials: S
authors.lastname: Ruan
authors.forename: Glenn F
authors.initials: GF
authors.lastname: Webb
authors.forename: Joanna R
authors.initials: JR
authors.lastname: Wares
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D050936:Basic Reproduction Number; D015169:Colony Count, Microbial; D016358:Contact Tracing; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission*; D024901:Drug Resistance, Multiple, Bacterial; D006235:Hand Disinfection; D006761:Hospitals; D006801:Humans; D017053:Infection Control; D008403:Mass Screening; D008954:Models, Biological; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents