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Effect of Patterns of Transferring Patients among Healthcare Institutions on Rates of Nosocomial Methicillin-Resistant Staphylococcus aureus Transmission: A Monte Carlo Simulation

Published online by Cambridge University Press:  02 January 2015

Maia Lesosky*
Affiliation:
Aalto University, Helsinki, Finland Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
Allison McGeer
Affiliation:
Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada
Andrew Simor
Affiliation:
Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Karen Green
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada
Don E. Low
Affiliation:
Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada
Janet Raboud
Affiliation:
Dalla Lana School of Public Health, University of Toronto, Ontario, Canada University Health Network, Toronto, Ontario, Canada
*
Aalto University, Institute of Mathematics, PO Box 1100, FI-02015 TKK, Helsinki, Finland (lesosky@gmail.com)

Abstract

Objective.

To determine the effect of the rate and pattern of patient transfers among institutions within a single metropolitan area on the rates of methicillin-resistant Staphylococcus aureus (MRSA) transmission among patients in hospitals and nursing homes.

Methods.

A stochastic, discrete-time, Monte Carlo simulation was used to model the rate and spread of MRSA transmission among patients in medical institutions within a single metropolitan area. Admission, discharges, transfers, and nosocomial transmission were simulated with respect to different interinstitutional transfer strategies and various situational scenarios, such as outlier institutions with high transmission rates.

Results.

The simulation results indicated that transfer patterns and transfer rate changes do not affect nosocomial MRSA transmission. Outlier institutions with high transmission rates affect the systemwide rate of nosocomial infections differently, depending on institution type.

Conclusion.

It is worth effort to understanding disease-transmission dynamics and interinstitutional transfer patterns for the management of recently introduced diseases or strains. Once endemic in a system, other strategies for transmission control need to be implemented.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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Effect of Patterns of Transferring Patients among Healthcare Institutions on Rates of Nosocomial Methicillin-Resistant Staphylococcus aureus Transmission: A Monte Carlo Simulation
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