ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
The Potential for Interventions in a Long-term Acute Care Hospital to Reduce Transmission of Carbapenem-Resistant Enterobacteriaceae in Affiliated Healthcare Facilities.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed.
- Developing Regionally Coordinated Infection Control Strategies for Carbapenem-Resistant and Carbapenemase-Producing Enterobacterales in Acute and Long-Term Care Hospitals: A Delphi Study.Journal of Korean medical science · 2026Article
- Screening and Cohorting of CRE Patients: The Strategic Role of Bed Management in a Monocentric Pre-Post Observational Study.Antibiotics (Basel, Switzerland) · 2026Article
- Phylogenetic Context of Antibiotic Resistance Provides Insights into the Dynamics of Resistance Emergence and Spread.The Journal of infectious diseases · 2025Article
- Inferring asymptomatic carriers of antimicrobial-resistant organisms in hospitals using genomic, microbiological and patient mobility data.Nature communications · 2025Article
- Transmission thresholds for the spread of infections in healthcare facilities.PLoS computational biology · 2025Article
- Risk factors for bloodstream infection and predictors of prognosis in rectal carriers of carbapenem-resistant Klebsiella pneumoniae.BMC infectious diseases · 2025Article
- The contribution of community transmission to the burden of hospital-associated pathogens: A systematic scoping review of epidemiological models.One health (Amsterdam, Netherlands) · 2025Review
- Identifying risk factors for carbapenem-resistant Acinetobacter baumannii carriage upon admission: a case-case control study.Antimicrobial resistance and infection control · 2024Article
- Expanding the use of mathematical modeling in healthcare epidemiology and infection prevention and control.Infection control and hospital epidemiology · 2024Review
- Regional impact of multidrug-resistant organism prevention bundles implemented by facility type: A modeling study.Infection control and hospital epidemiology · 2024Article
- Concurrent transmission of multiple carbapenemases in a long-term acute-care hospital.Infection control and hospital epidemiology · 2024Review
- System identifiability in a time-evolving agent-based model.PloS one · 2024Article
- Model-based evaluation of admission screening strategies for the detection and control of carbapenemase-producing Enterobacterales in the English hospital setting.BMC medicine · 2023Article
- Distinct Origins and Transmission Pathways ofJournal of clinical microbiology · 2023Article
- Clinical characteristics of carbapenem-resistantBMJ open · 2023Article
- Challenges in Forecasting Antimicrobial Resistance.Emerging infectious diseases · 2023Review
- Risk factors for colonization with multidrug-resistant Gram-negative bacteria andFrontiers in cellular and infection microbiology · 2023Article
- Identifying asymptomatic spreaders of antimicrobial-resistant pathogens in hospital settings.Proceedings of the National Academy of Sciences of the United States of America · 2021Article
- Carbapenem-resistant Enterobacterales bacteriuria and subsequent bacteremia: A population-based study.Infection control and hospital epidemiology · 2021Article
- Epidemiology and Transmission of Carbapenemase-ProducingAntimicrobial agents and chemotherapy · 2021Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundCarbapenem-resistant Enterobacteriaceae (CRE) are high-priority bacterial pathogens targeted for efforts to decrease transmissions and infections in healthcare facilities. Some regions have experienced CRE outbreaks that were likely amplified by frequent transmission in long-term acute care hospitals (LTACHs). Planning and funding of intervention efforts focused on LTACHs is one proposed strategy to contain outbreaks; however, the potential regional benefits of such efforts are unclear.
methodsWe designed an agent-based simulation model of patients in a regional network of 10 healthcare facilities including 1 LTACH, 3 short-stay acute care hospitals (ACHs), and 6 nursing homes (NHs). The model was calibrated to achieve realistic patient flow and CRE transmission and detection rates. We then simulated the initiation of an entirely LTACH-focused intervention in a previously CRE-free region, including active surveillance for CRE carriers and enhanced isolation of identified carriers.
resultsWhen initiating the intervention at the first clinical CRE detection in the LTACH, cumulative CRE transmissions over 5 years across all 10 facilities were reduced by 79%-93% compared to no-intervention simulations. This result was robust to changing assumptions for transmission within non-LTACH facilities and flow of patients from the LTACH. Delaying the intervention until the 20th CRE detection resulted in substantial delays in achieving optimal regional prevalence, while still reducing transmissions by 60%-79% over 5 years.
conclusionsFocusing intervention efforts on LTACHs is potentially a highly efficient strategy for reducing CRE transmissions across an entire region, particularly when implemented as early as possible in an emerging outbreak.
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