ArticleInfection control and hospital epidemiology2026
Estimating the impact of patient-level risk factors and time-varying hospital unit on healthcare-associated
Article in Infection control and hospital epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo deconstruct the multiple levels of risk factors for STUDY DESIGN AND
settingCase-control study of patients hospitalized in three acute care Delaware hospitals, December 2019-December 2023. PATIENTS: Cases were patients aged ≥18 years who tested positive for hospital-onset
methodsHierarchical and cross-classified MLMs were used to calculate odds of
resultsOur study included 1,223 patients (249 cases, 974 controls). In both models, greater odds of infection were associated with antibiotic exposure [adjusted odds ratio (aOR) = 11.20, 95% confidence interval (CI) = 7.19, 17.40; aOR = 12.80, 95% CI = 8.46, 19.40 for hierarchical and cross-classified models respectively] and health insurance (aOR = 1.74, 95% CI = 1.12, 2.68; aOR = 1.62, 95% CI = 1.03, 2.53; public vs. private). Median odds ratios (MOR) for both models indicated greater relevance of between-unit heterogeneity in the outcome than health insurance but less than antibiotic exposure (MOR = 1.83, 95% CI = 1.56, 2.30 and 2.71 95% CI = 2.10, 4.06).
conclusionUsing multilevel methods accounting for patient movement, we found that while antibiotic use is the most important risk factor in patients that developed
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