Abstract:
:OBJECTIVE Recerntly, the role of the healthcare network, defined as a set of hospitals linked by patient transfers, has been increasingly considered in the control of antimicrobial resistance. Here, we investigate the potential impact of nursing homes on the spread of antimicrobial-resistant pathogens across the healthcare network and its importance for control strategies. METHODS Based on patient transfer data, we designed a network model representing the Dutch healthcare system of hospitals and nursing homes. We simulated the spread of an antimicrobial-resistant pathogen across the healthcare network, and we modeled transmission within institutions using a stochastic susceptible-infected-susceptible (SIS) epidemic model. Transmission between institutions followed transfers. We identified the contribution of nursing homes to the dispersal of the pathogen by comparing simulations of the network with and without nursing homes. RESULTS Our results strongly suggest that nursing homes in the Netherlands have the potential to drive and sustain epidemics across the healthcare network. Even when the daily probability of transmission in nursing homes is much lower than in hospitals, transmission of resistance can be more effective because of the much longer length of stay of patients in nursing homes. CONCLUSIONS If an antimicrobial-resistant pathogen emerges that spreads easily within nursing homes, control efforts aimed at hospitals may no longer be effective in preventing nationwide outbreaks. It is important to consider nursing homes in planning regional and national infection control and in implementing surveillance systems that monitor the spread of antimicrobial resistance. Infect Control Hosp Epidemiol 2016;37:761-767.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
van den Dool C,Haenen A,Leenstra T,Wallinga Jdoi
10.1017/ice.2016.59subject
Has Abstractpub_date
2016-07-01 00:00:00pages
761-7issue
7eissn
0899-823Xissn
1559-6834pii
S0899823X16000593journal_volume
37pub_type
杂志文章abstract::Thorough counseling with emphasis on the importance of mosquito bite avoidance, as well as on compliance with prophylactic antimalarial regimens, remains an important task for the physician preparing a patient for international travel. Chloroquine continues to be the drug of choice for prophylaxis in areas not reporti...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
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abstract:OBJECTIVE:To determine whether methodological differences explain divergent results in case-control studies examining surgery as a risk factor for Creutzfeldt-Jakob disease (CJD). METHODS:After case-control studies were systematically identified using PubMed, we performed a homogeneity analysis and applied models to e...
journal_title:Infection control and hospital epidemiology
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journal_title:Infection control and hospital epidemiology
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journal_title:Infection control and hospital epidemiology
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journal_title:Infection control and hospital epidemiology
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journal_title:Infection control and hospital epidemiology
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更新日期:2016-10-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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journal_title:Infection control and hospital epidemiology
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:2014-05-01 00:00:00
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