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dc.contributor.authorKlein, E.Y.
dc.contributor.authorTseng, K.K.
dc.contributor.authorGoodman, K.E.
dc.date.accessioned2020-07-15T19:33:39Z
dc.date.available2020-07-15T19:33:39Z
dc.date.issued2020
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85087418626&doi=10.1093%2fofid%2fofaa056&partnerID=40&md5=11ddbfef5b7969625ac37a2b639b00e8
dc.identifier.urihttp://hdl.handle.net/10713/13313
dc.description.abstractBackground. User- and time-stamped data from hospital electronic health records (EHRs) present opportunities to evaluate how healthcare worker (HCW)-mediated contact networks impact transmission of multidrug-resistant pathogens, such as vancomycin-resistant enterococci (VRE). Methods. This is a retrospective analysis of incident acquisitions of VRE between July 1, 2016 and June 30, 2018. Clinical and demographic patient data were extracted from the hospital EHR system, including all recorded HCW contacts with patients. Contacts by an HCW with 2 different patients within 1 hour was considered a “connection”. Incident VRE acquisition was determined by positive clinical or surveillance cultures collected ≥72 hours after a negative surveillance culture. Results. There were 2952 hospitalizations by 2364 patients who had ≥2 VRE surveillance swabs, 112 (4.7%) patients of which had incident nosocomial acquisitions. Patients had a median of 24 (interquartile range [IQR], 18–33) recorded HCW contacts per day, 9 (IQR, 5–16) of which, or approximately 40%, were connections that occurred <1 hour after another patient contact. Patients that acquired VRE had a higher average number of daily connections to VRE-positive patients (3.1 [standard deviation {SD}, 2.4] versus 2.0 [SD, 2.1]). Controlling for other risk factors, connection to a VRE-positive patient was associated with increased odds of acquiring VRE (odds ratio, 1.64; 95% confidence interval, 1.39–1.92). Conclusions. We demonstrated that EHR data can be used to quantify the impact of HCW-mediated patient connections on transmission of VRE in the hospital. Defining incident acquisition risk of multidrug-resistant organisms through HCWs connections from EHR data in real-time may aid implementation and evaluation of interventions to contain their spread. copyright The Author(s) 2020.en_US
dc.description.sponsorship1U01CK000536; Centers for Disease Control and Prevention, CDC 1U54CK000447en_US
dc.description.urihttps://doi.org/10.1093/ofid/ofaa056en_US
dc.language.isoen_USen_US
dc.publisherOxford University Pressen_US
dc.relation.ispartofOpen Forum Infectious Diseases
dc.subjectAntibiotic resistanceen_US
dc.subjectElectronic health recordsen_US
dc.subjectHospital-acquired infectionsen_US
dc.subjectNosocomialen_US
dc.subjectPathogen surveillanceen_US
dc.titleThe role of healthcare worker-mediated contact networks in the transmission of vancomycin-resistant enterococcien_US
dc.typeArticleen_US
dc.identifier.doi10.1093/ofid/ofaa056


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