Detailed contact data and the dissemination of Staphylococcus aureus in hospitals

PLoS Comput Biol. 2015 Mar 19;11(3):e1004170. doi: 10.1371/journal.pcbi.1004170. eCollection 2015 Mar.

Abstract

Close proximity interactions (CPIs) measured by wireless electronic devices are increasingly used in epidemiological models. However, no evidence supports that electronically collected CPIs inform on the contacts leading to transmission. Here, we analyzed Staphylococcus aureus carriage and CPIs recorded simultaneously in a long-term care facility for 4 months in 329 patients and 261 healthcare workers to test this hypothesis. In the broad diversity of isolated S. aureus strains, 173 transmission events were observed between participants. The joint analysis of carriage and CPIs showed that CPI paths linking incident cases to other individuals carrying the same strain (i.e. possible infectors) had fewer intermediaries than predicted by chance (P < 0.001), a feature that simulations showed to be the signature of transmission along CPIs. Additional analyses revealed a higher dissemination risk between patients via healthcare workers than via other patients. In conclusion, S. aureus transmission was consistent with contacts defined by electronically collected CPIs, illustrating their potential as a tool to control hospital-acquired infections and help direct surveillance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Computational Biology
  • Cross Infection / epidemiology*
  • Cross Infection / transmission*
  • Female
  • Hospitals
  • Humans
  • Male
  • Middle Aged
  • Models, Biological
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / transmission*
  • Staphylococcus aureus*
  • Young Adult

Grant support

This study was supported by the European Commission under the Life Science Health Priority of the 6th Framework Program (MOSAR network contract LSHP-CT-2007-037941). Funding was also received from the French Government through the National Clinical Research Program and the Investissement d'Avenir program, Laboratoire d'Excellence "Integrative Biology of Emerging Infectious Diseases" (grant no. ANR-10-LABX-62-IBEID). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.