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Modeling nosocomial transmission of carbapenem-resistant bacteria

机译：模拟耐碳青霉烯细菌的医院内传播

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摘要

Patient acquisition of carbapenem resistant bacteria in hospitals is a serious problem that leads to adverse outcomes for infected patients. The most common carbapenem resistance mechanism in US hospitals is a mobile gene called Klebsiella pneumoniae carbapenemase (KPC), which can move between bacterial species. Previous research has demonstrated that patient-to-patient transmission cannot fully account for all cases of KPC-positive bacterial transmission in hospital settings. The study in this paper considers environmental reservoirs as an additional source of transmission. We conduct this analysis with logistic regression and random forest models of nosocomial transmission that includes both environmental factors and clinical data. Results show that infection rates are not uniformly distributed throughout the hospital and that differences in room layout play a role. However, proximity to KPC-positive Enterobacteriaceae environmental reservoirs does not significantly correlate to patient acquisition.
机译：医院中患者对碳青霉烯抗性细菌的获取是一个严重的问题，导致感染患者的不良后果。在美国医院中，最常见的碳青霉烯耐药机制是一种称为肺炎克雷伯氏菌碳青霉烯酶（KPC）的移动基因，它可以在细菌种类之间移动。先前的研究表明，在医院环境中，患者之间的传播不能完全解决KPC阳性细菌传播的所有情况。本文的研究认为环境水库是一种额外的传播来源。我们使用逻辑回归和医院传播的随机森林模型进行分析，其中包括环境因素和临床数据。结果表明，感染率在整个医院中分布不均，房间布局的差异也很重要。但是，靠近KPC阳性肠杆菌科环境储库与患者的获取没有显着相关。

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