PMID- 32166095
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240229
IS  - 2328-8957 (Print)
IS  - 2328-8957 (Electronic)
IS  - 2328-8957 (Linking)
VI  - 7
IP  - 3
DP  - 2020 Mar
TI  - The Role of Healthcare Worker-Mediated Contact Networks in the Transmission of 
      Vancomycin-Resistant Enterococci.
PG  - ofaa056
LID - 10.1093/ofid/ofaa056 [doi]
LID - ofaa056
AB  - BACKGROUND: 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.
CI  - (c) The Author(s) 2020. Published by Oxford University Press on behalf of 
      Infectious Diseases Society of America.
FAU - Klein, Eili Y
AU  - Klein EY
AUID- ORCID: 0000-0002-1304-5289
AD  - The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
AD  - Center for Disease Dynamics, Economics & Policy, Washington, District of 
      Columbia, USA.
FAU - Tseng, Katie K
AU  - Tseng KK
AD  - Center for Disease Dynamics, Economics & Policy, Washington, District of 
      Columbia, USA.
FAU - Hinson, Jeremiah
AU  - Hinson J
AD  - The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
FAU - Goodman, Katherine E
AU  - Goodman KE
AD  - The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
AD  - University of Maryland School of Medicine, Baltimore, Maryland, USA.
FAU - Smith, Aria
AU  - Smith A
AD  - The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
FAU - Toerper, Matt
AU  - Toerper M
AD  - The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
FAU - Amoah, Joe
AU  - Amoah J
AD  - The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
FAU - Tamma, Pranita D
AU  - Tamma PD
AD  - The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
FAU - Levin, Scott R
AU  - Levin SR
AD  - The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
FAU - Milstone, Aaron M
AU  - Milstone AM
AD  - The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
LA  - eng
GR  - U01 CK000536/CK/NCEZID CDC HHS/United States
GR  - U01 CK000589/CK/NCEZID CDC HHS/United States
GR  - U01CK000536/ACL/ACL HHS/United States
GR  - U54CK000447/ACL/ACL HHS/United States
PT  - Journal Article
DEP - 20200215
PL  - United States
TA  - Open Forum Infect Dis
JT  - Open forum infectious diseases
JID - 101637045
PMC - PMC7060899
OTO - NOTNLM
OT  - antibiotic resistance
OT  - electronic health records
OT  - hospital-acquired infections
OT  - nosocomial
OT  - pathogen surveillance
EDAT- 2020/03/14 06:00
MHDA- 2020/03/14 06:01
PMCR- 2020/02/15
CRDT- 2020/03/14 06:00
PHST- 2020/01/26 00:00 [received]
PHST- 2020/02/13 00:00 [accepted]
PHST- 2020/03/14 06:00 [entrez]
PHST- 2020/03/14 06:00 [pubmed]
PHST- 2020/03/14 06:01 [medline]
PHST- 2020/02/15 00:00 [pmc-release]
AID - ofaa056 [pii]
AID - 10.1093/ofid/ofaa056 [doi]
PST - epublish
SO  - Open Forum Infect Dis. 2020 Feb 15;7(3):ofaa056. doi: 10.1093/ofid/ofaa056. 
      eCollection 2020 Mar.