Abstract
Veterinary nosocomial infections caused by antibiotic resistant bacteria cause increased morbidity, higher cost and length of treatment and increased zoonotic risk because of the difficulty in treating them. In this study, an individual-based model was developed to investigate the effects of movements of canine patients among ten areas (transmission points) within a veterinary teaching hospital, and the effects of these movements on transmission of antibiotic susceptible and resistant pathogens. The model simulates contamination of transmission points, healthcare workers, and patients as well as the effects of decontamination of transmission points, disinfection of healthcare workers, and antibiotic treatments of canine patients. The model was parameterized using data obtained from hospital records, information obtained by interviews with hospital staff, and the published literature. The model suggested that transmission resulting from contact with healthcare workers was common, and that certain transmission points (housing wards, diagnostics room, and the intensive care unit) presented higher risk for transmission than others (lobby and surgery). Sensitivity analyses using a range of parameter values demonstrated that the risk of acquisition of colonization by resistant pathogens decreased with shorter patient hospital stays (P<0.0001), more frequent decontamination of transmission points and disinfection of healthcare workers (P<0.0001) and better compliance of healthcare workers with hygiene practices (P<0.0001). More frequent decontamination of heavily trafficked transmission points was especially effective at reducing transmission of the model pathogen.
Highlights
Antimicrobial resistance is a growing concern in modern health care settings as it increases morbidity, cost of treatment and mortality [1]
We developed an individual-based model (IBM) that tracks the movement of patients across the different points in the veterinary hospital where they come into contact with healthcare workers and various surfaces
Patient visits in the housing wards and the intensive care unit (ICU) area lead to colonization of the largest proportions of patients by the nonresistant strain
Summary
Antimicrobial resistance is a growing concern in modern health care settings as it increases morbidity, cost of treatment and mortality [1]. In veterinary hospitals the risk factors for nosocomial infections are similar to those in human healthcare settings. Use of invasive procedures, prolonged treatment and hospitalization and reliance on antimicrobials increase the risk of amplifying and transmitting antimicrobial resistant pathogens in veterinary hospitals [9,10]. Escherichia coli and Klebsiella spp. in particular have been strongly associated with urinary tract infections among human patients [11,12]. Canine cases of urinary tract infections caused by E. coli and Klebsiella pneumoniae are commonly diagnosed in veterinary settings and increasing numbers of antibiotic resistance cases in these bacterial species have made effective treatment more difficult [13]
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