An Individual-Based Model of Transmission of Resistant Bacteria in a Veterinary Teaching Hospital

• Published in: PloS one Vol. 9; no. 6; p. e98589
• Main Authors: Suthar, Neeraj, Roy, Sandip, Call, Douglas R., Besser, Thomas E., Davis, Margaret A.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03.06.2014; Public Library of Science (PLoS)
• Subjects: Allen, Paul G; Animals; Anti-Bacterial Agents - therapeutic use; Antibiotic resistance; Antibiotics; Bacteria; Bacterial Infections - drug therapy; Bacterial Infections - transmission; Biology and Life Sciences; Colonization; Computer simulation; Contamination; Cross Infection - transmission; Decontamination; Disease transmission; Disinfection; Drug resistance; Drug Resistance, Bacterial; Escherichia coli; Health aspects; Health care; Hospitals; Hospitals, Animal - statistics & numerical data; Hospitals, Teaching - statistics & numerical data; Housing; Hygiene; Infection; Infection control; Klebsiella pneumoniae; Medical personnel; Medicine and Health Sciences; Morbidity; Nosocomial infection; Nosocomial infections; Parameter sensitivity; Pathogens; Patients; Risk; Sensitivity analysis; Surgery; Veterinarians; Veterinary colleges; Veterinary medicine; Workers; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0098589

Veterinary nosocomial infections caused by antibiotic resistant bacteria cause increased morbidity, higher cost and length of treatment and increased zoonotic risk because of the difficulty in treating them. In this study, an individual-based model was developed to investigate the effects of movements of canine patients among ten areas (transmission points) within a veterinary teaching hospital, and the effects of these movements on transmission of antibiotic susceptible and resistant pathogens. The model simulates contamination of transmission points, healthcare workers, and patients as well as the effects of decontamination of transmission points, disinfection of healthcare workers, and antibiotic treatments of canine patients. The model was parameterized using data obtained from hospital records, information obtained by interviews with hospital staff, and the published literature. The model suggested that transmission resulting from contact with healthcare workers was common, and that certain transmission points (housing wards, diagnostics room, and the intensive care unit) presented higher risk for transmission than others (lobby and surgery). Sensitivity analyses using a range of parameter values demonstrated that the risk of acquisition of colonization by resistant pathogens decreased with shorter patient hospital stays (P<0.0001), more frequent decontamination of transmission points and disinfection of healthcare workers (P<0.0001) and better compliance of healthcare workers with hygiene practices (P<0.0001). More frequent decontamination of heavily trafficked transmission points was especially effective at reducing transmission of the model pathogen.