Modeling the spread of methicillin-resistant staphylococcus aureus (MRSA) outbreaks throughout the hospitals in Orange County, California

Bruce Y. Lee, Sarah M. McGlone, Kim F. Wong, S. Levent Yilmaz, Taliser R. Avery, Yeohan Song, Richard Christie, Stephen Eubank, Shawn T. Brown, Joshua Epstein, Jon I. Parker, Donald S. Burke, Richard Platt, Susan S. Huang

Research output: Contribution to journalArticle

Abstract

Background. Since hospitals in a region often share patients, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in one hospital could affect other hospitals. methods. Using extensive data collected from Orange County (OC), California, we developed a detailed agent-based model to represent patient movement among all OC hospitals. Experiments simulated MRSA outbreaks in various wards, institutions, and regions. Sensitivity analysis varied lengths of stay, intraward transmission coefficients (β), MRSA loss rate, probability of patient transfer or readmission, and time to readmission. results. Each simulated outbreak eventually affected all of the hospitals in the network, with effects depending on the outbreak size and location. Increasing MRSA prevalence at a single hospital (from 5% to 15%) resulted in a 2.9% average increase in relative prevalence at all other hospitals (ranging from no effect to 46.4%). Single-hospital intensive care unit outbreaks (modeled increase from 5% to 15%) caused a 1.4% average relative increase in all other OC hospitals (ranging from no effect to 12.7%). conclusion. MRSA outbreaks may rarely be confined to a single hospital but instead may affect all of the hospitals in a region. This suggests that prevention and control strategies and policies should account for the interconnectedness of health care facilities.

Original languageEnglish (US)
Pages (from-to)562-572
Number of pages11
JournalInfection Control and Hospital Epidemiology
Volume32
Issue number6
DOIs
StatePublished - Jun 2011

Fingerprint

Methicillin-Resistant Staphylococcus aureus
Disease Outbreaks
County Hospitals
Patient Transfer
Patient Readmission
Health Facilities
Intensive Care Units
Length of Stay
Delivery of Health Care
Infection

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Modeling the spread of methicillin-resistant staphylococcus aureus (MRSA) outbreaks throughout the hospitals in Orange County, California. / Lee, Bruce Y.; McGlone, Sarah M.; Wong, Kim F.; Yilmaz, S. Levent; Avery, Taliser R.; Song, Yeohan; Christie, Richard; Eubank, Stephen; Brown, Shawn T.; Epstein, Joshua; Parker, Jon I.; Burke, Donald S.; Platt, Richard; Huang, Susan S.

In: Infection Control and Hospital Epidemiology, Vol. 32, No. 6, 06.2011, p. 562-572.

Research output: Contribution to journalArticle

Lee, BY, McGlone, SM, Wong, KF, Yilmaz, SL, Avery, TR, Song, Y, Christie, R, Eubank, S, Brown, ST, Epstein, J, Parker, JI, Burke, DS, Platt, R & Huang, SS 2011, 'Modeling the spread of methicillin-resistant staphylococcus aureus (MRSA) outbreaks throughout the hospitals in Orange County, California', Infection Control and Hospital Epidemiology, vol. 32, no. 6, pp. 562-572. https://doi.org/10.1086/660014
Lee, Bruce Y. ; McGlone, Sarah M. ; Wong, Kim F. ; Yilmaz, S. Levent ; Avery, Taliser R. ; Song, Yeohan ; Christie, Richard ; Eubank, Stephen ; Brown, Shawn T. ; Epstein, Joshua ; Parker, Jon I. ; Burke, Donald S. ; Platt, Richard ; Huang, Susan S. / Modeling the spread of methicillin-resistant staphylococcus aureus (MRSA) outbreaks throughout the hospitals in Orange County, California. In: Infection Control and Hospital Epidemiology. 2011 ; Vol. 32, No. 6. pp. 562-572.
@article{2994c99771134a9b9dd721547c9a89f3,
title = "Modeling the spread of methicillin-resistant staphylococcus aureus (MRSA) outbreaks throughout the hospitals in Orange County, California",
abstract = "Background. Since hospitals in a region often share patients, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in one hospital could affect other hospitals. methods. Using extensive data collected from Orange County (OC), California, we developed a detailed agent-based model to represent patient movement among all OC hospitals. Experiments simulated MRSA outbreaks in various wards, institutions, and regions. Sensitivity analysis varied lengths of stay, intraward transmission coefficients (β), MRSA loss rate, probability of patient transfer or readmission, and time to readmission. results. Each simulated outbreak eventually affected all of the hospitals in the network, with effects depending on the outbreak size and location. Increasing MRSA prevalence at a single hospital (from 5{\%} to 15{\%}) resulted in a 2.9{\%} average increase in relative prevalence at all other hospitals (ranging from no effect to 46.4{\%}). Single-hospital intensive care unit outbreaks (modeled increase from 5{\%} to 15{\%}) caused a 1.4{\%} average relative increase in all other OC hospitals (ranging from no effect to 12.7{\%}). conclusion. MRSA outbreaks may rarely be confined to a single hospital but instead may affect all of the hospitals in a region. This suggests that prevention and control strategies and policies should account for the interconnectedness of health care facilities.",
author = "Lee, {Bruce Y.} and McGlone, {Sarah M.} and Wong, {Kim F.} and Yilmaz, {S. Levent} and Avery, {Taliser R.} and Yeohan Song and Richard Christie and Stephen Eubank and Brown, {Shawn T.} and Joshua Epstein and Parker, {Jon I.} and Burke, {Donald S.} and Richard Platt and Huang, {Susan S.}",
year = "2011",
month = "6",
doi = "10.1086/660014",
language = "English (US)",
volume = "32",
pages = "562--572",
journal = "Infection Control and Hospital Epidemiology",
issn = "0899-823X",
publisher = "University of Chicago Press",
number = "6",

}

TY - JOUR

T1 - Modeling the spread of methicillin-resistant staphylococcus aureus (MRSA) outbreaks throughout the hospitals in Orange County, California

AU - Lee, Bruce Y.

AU - McGlone, Sarah M.

AU - Wong, Kim F.

AU - Yilmaz, S. Levent

AU - Avery, Taliser R.

AU - Song, Yeohan

AU - Christie, Richard

AU - Eubank, Stephen

AU - Brown, Shawn T.

AU - Epstein, Joshua

AU - Parker, Jon I.

AU - Burke, Donald S.

AU - Platt, Richard

AU - Huang, Susan S.

PY - 2011/6

Y1 - 2011/6

N2 - Background. Since hospitals in a region often share patients, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in one hospital could affect other hospitals. methods. Using extensive data collected from Orange County (OC), California, we developed a detailed agent-based model to represent patient movement among all OC hospitals. Experiments simulated MRSA outbreaks in various wards, institutions, and regions. Sensitivity analysis varied lengths of stay, intraward transmission coefficients (β), MRSA loss rate, probability of patient transfer or readmission, and time to readmission. results. Each simulated outbreak eventually affected all of the hospitals in the network, with effects depending on the outbreak size and location. Increasing MRSA prevalence at a single hospital (from 5% to 15%) resulted in a 2.9% average increase in relative prevalence at all other hospitals (ranging from no effect to 46.4%). Single-hospital intensive care unit outbreaks (modeled increase from 5% to 15%) caused a 1.4% average relative increase in all other OC hospitals (ranging from no effect to 12.7%). conclusion. MRSA outbreaks may rarely be confined to a single hospital but instead may affect all of the hospitals in a region. This suggests that prevention and control strategies and policies should account for the interconnectedness of health care facilities.

AB - Background. Since hospitals in a region often share patients, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in one hospital could affect other hospitals. methods. Using extensive data collected from Orange County (OC), California, we developed a detailed agent-based model to represent patient movement among all OC hospitals. Experiments simulated MRSA outbreaks in various wards, institutions, and regions. Sensitivity analysis varied lengths of stay, intraward transmission coefficients (β), MRSA loss rate, probability of patient transfer or readmission, and time to readmission. results. Each simulated outbreak eventually affected all of the hospitals in the network, with effects depending on the outbreak size and location. Increasing MRSA prevalence at a single hospital (from 5% to 15%) resulted in a 2.9% average increase in relative prevalence at all other hospitals (ranging from no effect to 46.4%). Single-hospital intensive care unit outbreaks (modeled increase from 5% to 15%) caused a 1.4% average relative increase in all other OC hospitals (ranging from no effect to 12.7%). conclusion. MRSA outbreaks may rarely be confined to a single hospital but instead may affect all of the hospitals in a region. This suggests that prevention and control strategies and policies should account for the interconnectedness of health care facilities.

UR - http://www.scopus.com/inward/record.url?scp=79957966376&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79957966376&partnerID=8YFLogxK

U2 - 10.1086/660014

DO - 10.1086/660014

M3 - Article

C2 - 21558768

AN - SCOPUS:79957966376

VL - 32

SP - 562

EP - 572

JO - Infection Control and Hospital Epidemiology

JF - Infection Control and Hospital Epidemiology

SN - 0899-823X

IS - 6

ER -