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Hajo Grundmann, Satoshi Hori, Bob Winter, Adriana Tami, Daren J. Austin, Risk Factors for the Transmission of Methicillin-Resistant Staphylococcus aureus in an Adult Intensive Care Unit: Fitting a Model to the Data, The Journal of Infectious Diseases, Volume 185, Issue 4, 15 February 2002, Pages 481–488, https://doi.org/10.1086/338568
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Abstract
Little is known about the amount of cross-transmission, the risk factors for infection, and the relative effectiveness of infection control procedures when methicillin-resistant Staphylococcus aureus (MRSA) infection occurs at highly endemic levels in intensive care units. A cohort study was done to identify exposures associated with cases that likely were the result of cross-transmission (i.e., occurring in clusters and with indistinguishable MRSA macrorestriction profiles). Fitting a simple stochastic model to the ascertained data allowed prediction of the effectiveness of infection control measures. Exposure to relative staff deficit (adjusted rate ratio, 1.05 independent; 95% confidence interval, 1.02–1.09) was the only factor significantly associated with potential transmission (P = .001). It was predicted that a 12% improvement in adherence to handhygiene policies might have compensated for staff shortage and prevented transmission during periods of overcrowding, shared care, and high workload but that this would be hard to achieve.