Social network analysis spots facilities at risk for KPC-CRE transmission
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Key takeaways:
- Using social network analysis, researchers identified 4,864 direct patient transfers between facilities.
- Five outbreaks were identified, with further analysis identifying five highly connected facilities.
HOUSTON — Using social network analysis, researchers were able to show how health care facilities in Colorado are connected by patient transfers, which allowed them to identify potential outbreak origins.
The data were presented at the Society for Healthcare Epidemiology of America Spring Conference.
“The Colorado Department of Public Health and Environment (CDPHE) detected a large outbreak (48 cases) of Klebsiella pneumoniae carbapenamase-producing Enterobacterales species (KPC-CRE) in several health care facilities,” Kristen Marshall, PhD, MPH, CDC Career Epidemiology Field Officer (CEFO) assigned to the CDPHE, told Healio.
“We examined how patients moved between these facilities to help the facilities improve infection prevention and stop the outbreak,” she said.
The researchers created a statewide patient transfer network using 2021-2022 Medicare beneficiary data, according to the study. Subnetworks were then isolated from the larger network to examine a cluster of facilities involved in a KPC-CRE outbreak — defined as two or more KPC-CRE cases related by whole-genome sequencing (WGS), which was conducted at the CDPHE State Lab.
Using these data, the researchers then conducted what they called “social network analysis” (SNA) — which Marshall explained allowed them to mathematically examine connections between different points and could help identify clusters, patterns and relationships that are not obvious in other data formats.
The SNA showed 4,864 direct patient transfers between 326 health care facilities, including 220 skilled nursing facilities, 50 acute-care hospitals, 32 critical access hospitals, six long-term acute-care hospitals, and 18 facilities not previously classified.
Using WGS the researchers identified five separate KPC-CRE outbreaks among 14 patients between February 2022 and January 2023, with further analysis identifying five “highly connected” facilities.
Paired with patient transfer data, this analysis allowed researchers to identify the potential locations of KPC-CRE transmission in four of the five identified outbreaks.
Based on these findings, Marshall concluded that patient transfer data is beneficial to public health and that, in general, SNA can be used by most facilities to better understand patient transfer patterns.
“Knowing where patients come from and where they are going helps infection prevention and emergency management planning,” she concluded.
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