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VRE increase at one hospital may affect all hospitals in region
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A 10% increase in vancomycin-resistant enterococci at any one hospital can lead to a nearly 3% increase in the infection at other hospitals in the county, according to study results published in the American Journal of Infection Control.
“[Vancomycin-resistant enterococci] can spread readily from one hospital to another, even when hospitals are relatively small or distant, so to adequately control [vancomycin-resistant enterococci] and other health care-associated infections, hospitals need to work together because they are intimately interconnected,” Bruce Y. Lee, MD, MBA, associate professor of international health at Johns Hopkins Bloomberg School of Public Health, told Infectious Disease News. “Currently, infection control programs, measures and incentives tend to be individual hospital-based, which doesn’t necessarily promote cooperation.”
Bruce Y. Lee
Lee and Regional Healthcare Ecosystem Analyst (RHEA) Team from Johns Hopkins University, the Pittsburgh Supercomputing Center (PSC), the University of Pittsburgh and the University of Calivrnia, Irvine, obtained patient data on admissions and transfers from all 29 adult acute care hospitals in Orange County, Calif. Using this data, they developed an agent-based model to determine changes in vancomycin-resistant enterococci (VRE) colonization prevalence in the hospitals, using the data on patient length of stay, location where patient was admitted and discharged, and patient movement between hospitals.
They found that a moderate increase in VRE prevalence in any one hospital led to an average increase of 2.8%, ranging from 0% to 61.9%, in prevalence in the other hospitals. The 2.8% increase translates to 11 VRE-colonized patients per 388 yearly admissions. Larger hospitals saw a greater increase in VRE prevalence, and patient length of stay did not affect the prevalence. These increases typically were seen after 1.5 years.
“Hopefully, these data will change how people think about VRE control and encourage more communication and cooperation among hospitals and infection control programs, as well as stimulate the installation of more financial and legal incentives to motivate hospitals to cooperate,” Lee said.
There are several key players in fostering this cooperation, he said, including policymakers, insurance companies, infection control specialists and patients.
Bruce Lee, MD, MBA, can be reached at bruceleemdmba@gmail.com.
Disclosure: The researchers report no relevant disclosures.
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