Evidence map›Paper›PMID 36907332›Full record

ArticleThe Journal of hospital infection2023

Modelling interventions and contact networks to reduce the spread of carbapenem-resistant organisms between individuals in the ICU.

D A Martínez, J Cai, G Lin, K E Goodman, R Paul, J Lessler, S R Levin, M Toerper, P J Simner, A M Milstone and 2 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of hospital infection, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Epidemiology of Carbapenemase-Producing Enterobacterales Carriage in a Paediatric Tertiary Health Care Centre of Ontario, Canada.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2024
    Article
  7. Bayesian Calibration to Address the Challenge of Antimicrobial Resistance: A Review.IEEE access : practical innovations, open solutions · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

D A MartínezSchool of Industrial Engineering, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile; Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University, Baltimore, MD, USA. Electronic address: dmart101@jhmi.edu.
J CaiDepartment of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA.
G LinCenter for Disease Dynamics, Economics and Policy, Washington, DC, USA.
K E GoodmanDepartment of Epidemiology and Public Health, University of Maryland, Baltimore, MD, USA.
R PaulDepartment of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA.
J LesslerDepartment of Epidemiology, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
S R LevinDepartment of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA.
M ToerperDepartment of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA.
P J SimnerDivision of Medical Microbiology, Department of Pathology, Johns Hopkins University, Baltimore, MD, USA.
A M MilstoneDepartment of Epidemiology, Johns Hopkins University, Baltimore, MD, USA; Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA.
E Y KleinDepartment of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA; Center for Disease Dynamics, Economics and Policy, Washington, DC, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
MInD-Healthcare
Johns Hopkins University · USCenter for Disease Dynamics, Economics & Policy · USUniversity of Maryland, Baltimore · USUniversity of North Carolina at Charlotte · US

Funding

Mentoring in prevention of hospital-acquired infections and antibiotic resistanceK24AI141580 · NIAID · JOHNS HOPKINS UNIVERSITY · PI AARON M MILSTONE · 2019 to 2026
$1.4M
ACL HHS U01CK000536ACL HHS U54CK000447NCEZID CDC HHS U01 CK000536NCEZID CDC HHS U54 CK000447NIAID NIH HHS K24 AI141580
6 · The paper itself

Abstract

backgroundContact precautions are widely used to prevent the transmission of carbapenem-resistant organisms (CROs) in hospital wards. However, evidence for their effectiveness in natural hospital environments is limited.

objectiveTo determine which contact precautions, healthcare worker (HCW)-patient interactions, and patient and ward characteristics are associated with greater risk of CRO infection or colonization. DESIGN, SETTING AND

participantsCRO clinical and surveillance cultures from two high-acuity wards were assessed through probabilistic modelling to characterize a susceptible patient's risk of CRO infection or colonization during a ward stay. User- and time-stamped electronic health records were used to build HCW-mediated contact networks between patients. Probabilistic models were adjusted for patient (e.g. antibiotic administration) and ward (e.g. hand hygiene compliance, environmental cleaning) characteristics. The effects of risk factors were assessed by adjusted odds ratio (aOR) and 95% Bayesian credible intervals (CrI). EXPOSURES: The degree of interaction with CRO-positive patients, stratified by whether CRO-positive patients were on contact precautions. MAIN OUTCOMES AND MEASURES: The prevalence of CROs and number of new carriers (i.e. incident CRO aquisition).

resultsAmong 2193 ward visits, 126 (5.8%) patients became colonized or infected with CROs. Susceptible patients had 4.8 daily interactions with CRO-positive individuals on contact precautions (vs 1.9 interactions with those not on contact precautions). The use of contact precautions for CRO-positive patients was associated with a reduced rate (7.4 vs 93.5 per 1000 patient-days at risk) and odds (aOR 0.03, 95% CrI 0.01-0.17) of CRO acquisition among susceptible patients, resulting in an estimated absolute risk reduction of 9.0% (95% CrI 7.6-9.2%). Also, carbapenem administration to susceptible patients was associated with increased odds of CRO acquisition (aOR 2.38, 95% CrI 1.70-3.29). CONCLUSIONS AND RELEVANCE: In this population-based cohort study, the use of contact precautions for patients colonized or infected with CROs was associated with lower risk of CRO acquisition among susceptible patients, even after adjusting for antibiotic exposure. Further studies that include organism genotyping are needed to confirm these findings.

Indexed as

Cross InfectionAnti-Bacterial AgentsBayes TheoremCarbapenemsCohort StudiesHumansInfection ControlIntensive Care UnitsAnti-Bacterial AgentsCarbapenemsAntibacterial drug resistanceCarbapenemsHealthcare worker–patientOperations researchTransmissionUniversal precautions

Identifiers

PMID36907332
PMCPMC10315994
OpenAlexW4323923622

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.