Hospital Transfer Network Structure as a Risk Factor for Clostridium difficile Infection

Area of Science:

• Epidemiology
• Healthcare-associated infections
• Network analysis

Background:

• Clostridium difficile (C. diff) infections pose a significant healthcare burden.
• Understanding transmission dynamics is crucial for effective infection control.
• Interhospital patient transfers represent a potential pathway for pathogen dissemination.

Purpose of the Study:

• To investigate the association between interhospital patient transfers and the incidence of C. diff infections.
• To quantify the impact of hospital network connectivity on C. diff rates.

Main Methods:

• Retrospective cohort study using California inpatient data (2005-2011).
• Construction of hospital transfer networks to calculate indegree and weighted indegree.
• Multivariate regression analysis incorporating network measures and patient/hospital covariates.

Main Results:

• A 1-unit increase in log indegree correlated with a 4.8% rise in C. diff incidence.
• A 1-unit increase in log weighted indegree correlated with a 3.3% rise in C. diff incidence.
• Network connectivity measures significantly improved model fit, indicating their importance.

Conclusions:

• Hospital infection control is influenced by external connections and patient sharing.
• Interhospital transfer networks play a role in C. diff transmission.
• Network-based approaches may enhance infection control strategies.