A statistical method for estimating the proportion of cases resulting from cross-transmission of multi-resistant pathogens in an intensive care unit.

Mikolajczyk RT, Sagel U, Bornemann R, Krämer A, Kretzschmar M (2007)
Journal of Hospital Infection 65(2): 149-155.

Journal Article | Published | English

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Abstract
Multi-resistant bacteria are an increasing challenge for infection control in hospitals and the proportion of patients newly colonized with multi-resistant bacteria during their hospital stay can be used to assess the effectiveness of infection control measures. Current laboratory methods for estimating this require expensive additional tests. We propose an alternative statistical method to estimate the proportion of cases resulting from transmission in a hospital from the distribution of time intervals between subsequent cases. A prerequisite for the application of this method is the existence of records from regular screening of the patients during their hospital stay, usually performed in intensive care units (ICUs). We describe the method and present an example of its application using records of two multi-resistant pathogens collected in an ICU over a three-year period. The estimated proportion of cases resulting from transmission was 0.73 (95% CI: 0.56-0.90) for meticillin-resistant Staphylococcus aureus and 0.45 (95% CI 0.15-0.75) for imipenem-resistant Pseudomonas aeruginosa. The method proposed here can be used for retrospective evaluation of clinical records in order to evaluate the effectiveness of infection control measures in low endemicity settings.
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Mikolajczyk RT, Sagel U, Bornemann R, Krämer A, Kretzschmar M. A statistical method for estimating the proportion of cases resulting from cross-transmission of multi-resistant pathogens in an intensive care unit. Journal of Hospital Infection. 2007;65(2):149-155.
Mikolajczyk, R. T., Sagel, U., Bornemann, R., Krämer, A., & Kretzschmar, M. (2007). A statistical method for estimating the proportion of cases resulting from cross-transmission of multi-resistant pathogens in an intensive care unit. Journal of Hospital Infection, 65(2), 149-155.
Mikolajczyk, R. T., Sagel, U., Bornemann, R., Krämer, A., and Kretzschmar, M. (2007). A statistical method for estimating the proportion of cases resulting from cross-transmission of multi-resistant pathogens in an intensive care unit. Journal of Hospital Infection 65, 149-155.
Mikolajczyk, R.T., et al., 2007. A statistical method for estimating the proportion of cases resulting from cross-transmission of multi-resistant pathogens in an intensive care unit. Journal of Hospital Infection, 65(2), p 149-155.
R.T. Mikolajczyk, et al., “A statistical method for estimating the proportion of cases resulting from cross-transmission of multi-resistant pathogens in an intensive care unit.”, Journal of Hospital Infection, vol. 65, 2007, pp. 149-155.
Mikolajczyk, R.T., Sagel, U., Bornemann, R., Krämer, A., Kretzschmar, M.: A statistical method for estimating the proportion of cases resulting from cross-transmission of multi-resistant pathogens in an intensive care unit. Journal of Hospital Infection. 65, 149-155 (2007).
Mikolajczyk, R. T., Sagel, U, Bornemann, Reinhard, Krämer, Alexander, and Kretzschmar, M. “A statistical method for estimating the proportion of cases resulting from cross-transmission of multi-resistant pathogens in an intensive care unit.”. Journal of Hospital Infection 65.2 (2007): 149-155.
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4 Citations in Europe PMC

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Acquisition and spread of Acinetobacter baumannii and Stenotrophomonas maltophilia in intensive care patients.
Barchitta M, Cipresso R, Giaquinta L, Romeo MA, Denaro C, Pennisi C, Agodi A., Int J Hyg Environ Health 212(3), 2009
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Pseudomonas aeruginosa carriage, colonization, and infection in ICU patients.
Agodi A, Barchitta M, Cipresso R, Giaquinta L, Romeo MA, Denaro C., Intensive Care Med 33(7), 2007
PMID: 17503016

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