ArticlePloS one2016
An Economic Analysis of Strategies to Control Clostridium Difficile Transmission and Infection Using an Agent-Based Simulation Model.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Simulation models for transmission of health care-associated infection: A systematic review.American journal of infection control · 2020Pooled it
- Spatial-temporal simulation for hospital infection spread and outbreaks of Clostridioides difficile.Scientific reports · 2023Article
- 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
- Method for Economic Evaluation of Bacterial Whole Genome Sequencing Surveillance Compared to Standard of Care in Detecting Hospital Outbreaks.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Evaluation of the Cost-effectiveness of Infection Control Strategies to Reduce Hospital-Onset Clostridioides difficile Infection.JAMA network open · 2020Article
- Fast and near-optimal monitoring for healthcare acquired infection outbreaks.PLoS computational biology · 2019Article
- Economic evaluation of interventions designed to reduce Clostridium difficile infection.PloS one · 2018Article
- Training to Proficiency in the WHO Hand Hygiene Technique.Journal of medical education and curricular developmentArticle
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundA number of strategies exist to reduce Clostridium difficile (C. difficile) transmission. We conducted an economic evaluation of "bundling" these strategies together.
methodsWe constructed an agent-based computer simulation of nosocomial C. difficile transmission and infection in a hospital setting. This model included the following components: interactions between patients and health care workers; 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. Six interventions were introduced alone and "bundled" together: (a) aggressive C. difficile testing; (b) empiric isolation and treatment of symptomatic patients; (c) improved adherence to hand hygiene and (d) contact precautions; (e) improved use of soap and water for hand hygiene; and (f) improved environmental cleaning. Our analysis compared these interventions using values representing 3 different scenarios: (1) base-case (BASE) values that reflect typical hospital practice, (2) intervention (INT) values that represent implementation of hospital-wide efforts to reduce C. diff transmission, and (3) optimal (OPT) values representing the highest expected results from strong adherence to the interventions. Cost parameters for each intervention were obtained from published literature. We performed our analyses assuming low, normal, and high C. difficile importation prevalence and transmissibility of C. difficile.
resultsINT levels of the "bundled" intervention were cost-effective at a willingness-to-pay threshold of $100,000/quality-adjusted life-year in all importation prevalence and transmissibility scenarios. OPT levels of intervention were cost-effective for normal and high importation prevalence and transmissibility scenarios. When analyzed separately, hand hygiene compliance, environmental decontamination, and empiric isolation and treatment were the interventions that had the greatest impact on both cost and effectiveness.
conclusionsA combination of available interventions to prevent CDI is likely to be cost-effective but the cost-effectiveness varies for different levels of intensity of the interventions depending on epidemiological conditions such as C. difficile importation prevalence and transmissibility.
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