ArticlePloS one2013
A simulation-based assessment of strategies to control Clostridium difficile transmission and infection.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Simulation models for transmission of health care-associated infection: A systematic review.American journal of infection control · 2020Pooled it
- Using contact network dynamics to implement efficient interventions against pathogen spread in hospital settings: A modelling study.PLoS medicine · 2024Article
- System identifiability in a time-evolving agent-based model.PloS one · 2024Article
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- Using spectral characterization to identify healthcare-associated infection (HAI) patients for clinical contact precaution.Scientific reports · 2023Article
- Validating agent-based simulation model of hospital-associated Clostridioides difficile infection using primary hospital data.PloS one · 2023Article
- A review of epidemiological models of Clostridioides difficile transmission and control (2009-2021).Anaerobe · 2022Review
- Mathematically modeling the effect of touch frequency on the environmental transmission of Clostridioides difficile in healthcare settings.Mathematical biosciences · 2021Article
- Identifying asymptomatic spreaders of antimicrobial-resistant pathogens in hospital settings.Proceedings of the National Academy of Sciences of the United States of America · 2021Article
- Comparing intervention strategies for reducing Clostridioides difficile transmission in acute healthcare settings: an agent-based modeling study.BMC infectious diseases · 2020Article
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- Some simple rules for estimating reproduction numbers in the presence of reservoir exposure or imported cases.Theoretical population biology · 2020Article
- ReducingInfection control and hospital epidemiology · 2020Article
- Article
- Model-based Assessment of the Effect of Contact Precautions Applied to Surveillance-detected Carriers of Carbapenemase-producing Enterobacteriaceae in Long-term Acute Care Hospitals.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Fast and near-optimal monitoring for healthcare acquired infection outbreaks.PLoS computational biology · 2019Article
- Modeling Clostridium difficile in a hospital setting: control and admissions of colonized and symptomatic patients.Theoretical biology & medical modelling · 2019Article
- EnABLe: An agent-based model to understand Listeria dynamics in food processing facilities.Scientific reports · 2019Article
- Interventions to Reduce the Incidence of Hospital-Onset Clostridium difficile Infection: An Agent-Based Modeling Approach to Evaluate Clinical Effectiveness in Adult Acute Care Hospitals.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Article
- Antimicrobial Stewardship and Environmental Decontamination for the Control of Clostridium difficile Transmission in Healthcare Settings.Bulletin of mathematical biology · 2017Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundClostridium difficile is one of the most common and important nosocomial pathogens, causing severe gastrointestinal disease in hospitalized patients. Although "bundled" interventions have been proposed and promoted, optimal control strategies remain unknown.
methodsWe designed an agent-based computer simulation of nosocomial C. difficile transmission and infection, which included components such as: patients and health care workers, and their interactions; room contamination via C. difficile shedding; C. difficile hand carriage and removal via hand hygiene; patient acquisition of C. difficile via contact with contaminated rooms or health care workers; and patient antimicrobial use. We then introduced six interventions, alone and "bundled" together: aggressive C. difficile testing; empiric isolation and treatment of symptomatic patients; improved adherence to hand hygiene and contact precautions; improved use of soap and water for hand hygiene; and improved environmental cleaning. All interventions were tested using values representing base-case, typical intervention, and optimal intervention scenarios.
findingsIn the base-case scenario, C. difficile infection rates ranged from 8-21 cases/10,000 patient-days, with a case detection fraction between 32%-50%. Implementing the "bundle" at typical intervention levels had a large impact on C. difficile acquisition and infection rates, although intensifying the intervention to optimal levels had much less additional impact. Most of the impact came from improved hand hygiene and empiric isolation and treatment of suspected C. difficile cases.
conclusionA "bundled" intervention is likely to reduce nosocomial C. difficile infection rates, even under typical implementation conditions. Real-world implementation of the "bundle" should focus on those components of the intervention that are likely to produce the greatest impact on C. difficile infection rates, such as hand hygiene and empiric isolation and treatment of suspected cases.
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