Abstract
Nosocomial transmission of viral and bacterial infections is a major problem worldwide, affecting millions of patients (and causing hundreds of thousands of deaths) per year. Rotavirus infections affect most children worldwide at least once before age five. We present here deterministic and stochastic models for the transmission of rotavirus in a pediatric hospital ward and draw on published data to compare the efficacy of several possible control measures in reducing the number of infections during a 90-day outbreak, including cohorting, changes in healthcare worker-patient ratio, improving compliance with preventive hygiene measures, and vaccination. Although recently approved vaccines have potential to curtail most nosocomial rotavirus transmission in the future, even short-term improvement in preventive hygiene compliance following contact with symptomatic patients may significantly limit transmission as well, and remains an important control measure, especially where resources are limited.
Keywords: Rotavirus, Nosocomial infections, Dynamical systems, Stochastic model, Preventive measures
References
- Allen L. J. S. An introduction to stochastic processes with applications to biology. Upper Saddle River: Pearson; 2003. [Google Scholar]
- Allen L. J. S., Allen E. J. A comparison of three different stochastic population models with regard to persistence time. Theor. Popul. Biol. 2003;64:439–449. doi: 10.1016/S0040-5809(03)00104-7. [DOI] [PubMed] [Google Scholar]
- Angel J., Franco M. A., Greenberg H. B. Rotavirus vaccines: recent developments and future considerations. Nature reviews. Microbiology. 2007;5(7):529–539. doi: 10.1038/nrmicro1692. [DOI] [PubMed] [Google Scholar]
- Austin D. J., Bonten M. J., Weinstein R. A., Slaughter S., Anderson R. M. Vancomycin-resistant enterococci in intensive-care hospital settings: transmission dynamics, persistence, and the impact of infection control programs. Proc. Natl. Acad. Sci. USA. 1999;96(12):6908–6913. doi: 10.1073/pnas.96.12.6908. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Avila-Agüero M. L., Umaña M. A., Jiménez A. L., Faingezicht I., París M. M. Handwashing practices in a tertiary-care, pediatric hospital and the effect of an educational program. Clin. Perform. Qual. Health Care. 1998;6(2):70–72. [PubMed] [Google Scholar]
- Boldin B., Bonten M. J. M., Diekmann O. Relative effects of barrier precautions and topical antibiotics on nosocomial bacterial transmission: results of multi-compartment models. Bull. Math. Biol. 2007;69:2227–2248. doi: 10.1007/s11538-007-9205-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bonten M. J. M., Austin D. J., Lipsitch M. Understanding the spread of antibiotic resistant pathogens in hospitals: mathematical models as tools for control. Clin. Infect. Dis. 2001;33:1739–1746. doi: 10.1086/323761. [DOI] [PubMed] [Google Scholar]
- Centers for Disease Control and Prevention Reduction in rotavirus after vaccine introduction—United States, 2000–2009. MMWR Wkly. 2009;58(41):1146–1149. [PubMed] [Google Scholar]
- Chandran A., Heinzen R. R., Santosham M., Siberry G. K. Nosocomial rotavirus infections: a systematic review. J. Pediatr. 2006;149:441–447. doi: 10.1016/j.jpeds.2006.04.054. [DOI] [PubMed] [Google Scholar]
- Chow, K. C., Wang, X., & Castillo-Chávez, C. (2007). A mathematical model of nosocomial infection and antibiotic resistance: evaluating the efficacy of antimicrobial cycling programs and patient isolation on dual resistance (MTBI Technical Report MTBI-04-05M). Arizona State University.
- Cone R., Mohan K., Thouless M., Corey L. Nosocomial transmission of rotavirus infection. Pediatr. Infect. Dis. J. 1988;7:103–109. doi: 10.1097/00006454-198802000-00008. [DOI] [PubMed] [Google Scholar]
- Cooper B. S., Medley G. F., Scott G. M. Preliminary analysis of the transmission dynamics of nosocomial infections: stochastic and management effects. J. Hosp. Infect. 1999;43:131–147. doi: 10.1053/jhin.1998.0647. [DOI] [PubMed] [Google Scholar]
- D’Agata E. M. C., Webb G., Horn M. A. A mathematical model quantifying the impact of antibiotic exposure and other interventions on the endemic prevalence of vancomycin-resistant enterococci. J. Infect. Dis. 2005;192:2004–2011. doi: 10.1086/498041. [DOI] [PubMed] [Google Scholar]
- D’Agata E. M. C., Magal P., Ruan S., Webb G. F. Asymptotic behavior in nosocomial epidemic models with antibiotic resistance. Differ. Integral Equ. 2006;19(5):573–600. [Google Scholar]
- D’Agata E. M. C., Magal P., Olivier D., Ruan S., Webb G. F. Modeling antibiotic resistance in hospitals: The impact of minimizing treatment duration. J. Theor. Biol. 2007;249:487–499. doi: 10.1016/j.jtbi.2007.08.011. [DOI] [PMC free article] [PubMed] [Google Scholar]
- D’Agata E. M. C., Dupont-Rouzeyrol M., Magal P., Olivier D., Ruan S. The impact of different antibiotic regimens on the emergence of antimicrobial-resistant bacteria. PLoS ONE. 2008;3(12):e4036. doi: 10.1371/journal.pone.0004036. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Diekmann O., Heesterbeek J. A. P., Metz J. A. J. On the definition and the computation of the basic reproduction ratio R0 in models for infectious diseases in heterogeneous population. J. Math. Biol. 1990;28:365–382. doi: 10.1007/BF00178324. [DOI] [PubMed] [Google Scholar]
- Fruhwirth M., Berger K., Ehlken B., Moll-Schuler I., Brosl S., Mutz I. Economic impact of community- and nosocomially acquired rotavirus gastroenteritis in Austria. Pediatr. Infect. Dis. J. 2001;20(2):184–188. doi: 10.1097/00006454-200102000-00013. [DOI] [PubMed] [Google Scholar]
- Gleizes O., Desselberger U., Tatochenko V., Rodrigo C., Salman N., Mezner Z., Giaquinto C., Grimprel E. Nosocomial rotavirus infection in European countries: a review of the epidemiology, severity and economic burden of hospital-acquired rotavirus disease. Pediatr. Infect. Dis. J. 2006;25(1):S12–S21. doi: 10.1097/01.inf.0000195626.35239.58. [DOI] [PubMed] [Google Scholar]
- Halloran M. E., Haber M., Longini I. M., Jr. Interpretation and estimation of vaccine efficacy under heterogeneity. Am. J. Epidemiol. 1992;136(3):328–343. doi: 10.1093/oxfordjournals.aje.a116498. [DOI] [PubMed] [Google Scholar]
- Hogg R. V., Craig A. T. Introduction to mathematical statistics. 4. New York: Macmillan; 1978. [Google Scholar]
- Jusot J.-F., Vanhems P., Benzait F., Berthelot P., Patural H., Teyssier G., Fabry J., Pozzetto P. Reported measures of hygiene and incidence rates for hospital-acquired diarrhea in 31 French pediatric wards: is there any relationship? Infect. Control Hosp. Epidemiol. 2003;24:520–525. doi: 10.1086/502238. [DOI] [PubMed] [Google Scholar]
- Lipsitch M., Bergstrom C. T., Levin B. R. The epidemiology of antibiotic resistance in hospitals: paradoxes and prescriptions. Proc. Natl. Acad. Sci. USA. 2000;97(4):1938–1943. doi: 10.1073/pnas.97.4.1938. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lopman B. A., Reacher M. H., Vipond I. B., Hill D., Perry C., Halladay T., et al. Epidemiology and cost of nosocomial gastroenteritis, Avon, England, 2002–2003. Emerg. Infect. Dis. 2004;10(10):1827–1834. doi: 10.3201/eid1010.030941. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Maille L., Beby-Defaux A., Bourgoin A., Koulmann L., Eucher V., Cardona J., Oriot D., Agius G. Infections nosocomiales à rotavirus et à virus respiratoire syncytial en milieu pédiatrique: étude sur une période de 2 ans. Ann. Biol. Clin. 2000;58(5):601–606. [PubMed] [Google Scholar]
- Nakata S., Adachi N., Ukae S., Kogawa K., Numata K., Urasawa S., Chiba S. Outbreaks of nosocomial rotavirus gastro-enteritis in a paediatric ward. Eur. J. Pediatr. 1996;155(11):954–958. doi: 10.1007/BF02282886. [DOI] [PubMed] [Google Scholar]
- Ontario Ministry of Health and Long-Term Care (2009). Hand hygiene compliance rates. http://www.health.gov.on.ca/patient_safety/public/hh/hh_pub.html.
- Pittet D., Hugonnet S., Harbarth S., Mourouga P., Sauvan V., Touveneau S., Perneger T. V., et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet. 2000;356:1307–1312. doi: 10.1016/S0140-6736(00)02814-2. [DOI] [PubMed] [Google Scholar]
- Ringenbergs M. L., Davidson G. P., Spence J., Morris S. Prospective study of nosocomial rotavirus infection in a paediatric hospital. Aust. Paediat. J. 1989;25:156–160. doi: 10.1111/j.1440-1754.1989.tb01441.x. [DOI] [PubMed] [Google Scholar]
- Rodrigues A., de Carvalho M., Monteiro S., Mikkelsen C. S., Aaby P., Molbak K., Fischer T. K. Hospital surveillance of rotavirus infection and nosocomial transmission of rotavirus disease among children in Guinea-Bissau. Pediatr. Infect. Dis. J. 2007;26(3):233–237. doi: 10.1097/01.inf.0000254389.65667.8b. [DOI] [PubMed] [Google Scholar]
- Ruiz-Palacios G., Pérez-Schael I., Velázquez F. R., Abate H., Breuer T., Clemens S. Costa, et al. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N. Engl. J. Med. 2006;354(1):11–22. doi: 10.1056/NEJMoa052434. [DOI] [PubMed] [Google Scholar]
- Ryder R. W., McGowan J. E., Jr, Hatch M. H., Palmer E. L. Reovirus-like agent as a cause of nosocomial diarrhea in infants. J. Pediatr. 1977;90(5):698–702. doi: 10.1016/S0022-3476(77)81230-4. [DOI] [PubMed] [Google Scholar]
- Sébille V., Chevret S., Valleron A.-J. Modeling the spread of resistant nosocomial pathogens in an intensive-care unit. Infect. Control Hosp. Epidemiol. 1997;18(2):84–92. doi: 10.1086/647560. [DOI] [PubMed] [Google Scholar]
- Sébille V., Valleron A.-J. A computer simulation model for the spread of nosocomial infections caused by multidrug-resistant pathogens. Comput. Biomed. Res. 1997;30:307–322. doi: 10.1006/cbmr.1997.1451. [DOI] [PubMed] [Google Scholar]
- Slota M., Green M., Farley A., Janosky J., Carcillo J. The role of gown and glove isolation and strict handwashing in the reduction of nosocomial infection in children with solid organ transplantation. Crit. Care Med. 2001;29(2):405–412. doi: 10.1097/00003246-200102000-00034. [DOI] [PubMed] [Google Scholar]
- Temime L., Opatowski L., Pannet Y., Brun-Buisson C., Boëlle P. Y., Guillemot D. Peripatetic health-care workers as potential superspreaders. Proc. Natl. Acad. Sci. USA. 2009;106(43):18420–18428. doi: 10.1073/pnas.0900974106. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thuret A., Patural H., Berthelot P., Benzait F., Martin I., Jusot J.-F., Teyssier G., Fabry J., Pozzetto B. Suivi prospectif des diarrhées nosocomiales dans 28 services de pédiatrie du quart Sud-Est de la France au cours d’un trimestre d’hiver [Prospective follow-up of hospital-acquired diarrhoea in 28 paediatric wards of the south-east part of France during a winter season] Pathol. Biol. 2004;52:131–137. doi: 10.1016/j.patbio.2003.06.005. [DOI] [PubMed] [Google Scholar]
- Tibballs J. Teaching hospital medical staff to handwash. Med. J. Aust. 1996;164:395–398. doi: 10.5694/j.1326-5377.1996.tb124899.x. [DOI] [PubMed] [Google Scholar]
- Vasselle, A. (2006). Prévenir les infections nosocomiales : une exigence de qualité des soins hospitaliers (Rapport d’information No. 421 (2005–2006)). Observatoire Parlementaire d’Evaluation des Politiques de Santé, (OPEPS). Available online at http://www.senat.fr/rap/r05-421/r05-421.html.
- Vesikari T., Matson D. O., Dennehy P., Van Damme P., Santosham M., Rodriguez Z., et al. Safety and efficacy of a pentavalent human-bovine, (WC3) reassortant rotavirus vaccine. N. Engl. J. Med. 2006;354(1):23–33. doi: 10.1056/NEJMoa052664. [DOI] [PubMed] [Google Scholar]
- Wallinga J., Lipsitch M. How generation intervals shape the relationship between growth rates and reproductive numbers. Proc. R. Soc. B. 2007;274:599–604. doi: 10.1098/rspb.2006.3754. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Webb G. F., Blaser M. J., Zhu H., Ardal S., Wu J. Critical role of nosocomial transmission in the Toronto SARS outbreak. Math. Biosci. Eng. 2004;1(1):1–13. doi: 10.3934/mbe.2004.1.1. [DOI] [PubMed] [Google Scholar]
- Webb G. F., D’Agata E. M. C., Magal P., Ruan S. A model of antibiotic-resistant bacterial epidemics in hospitals. Proc. Natl. Acad. Sci. USA. 2005;102(37):13343–13348. doi: 10.1073/pnas.0504053102. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Weinstein R. A. Nosocomial infection update. Emerg. Infect. Dis. 1998;4(3):416–420. doi: 10.3201/eid0403.980320. [DOI] [PMC free article] [PubMed] [Google Scholar]
