Network analysis of cases with methicillin-resistant Staphylococcus aureus and controls in a large tertiary care...

Area of Science:

• Healthcare epidemiology
• Infectious disease transmission
• Network science

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) continues to spread in healthcare settings despite infection control measures, causing significant morbidity and healthcare costs.
• Understanding transmission dynamics is crucial for effective control of MRSA outbreaks in tertiary care facilities.

Purpose of the Study:

• To identify risk factors for MRSA acquisition in a tertiary healthcare facility.
• To validate changes in healthcare network structures during pre-outbreak and outbreak periods.

Main Methods:

• A historic case-control study was conducted, comparing MRSA-infected/colonized patients (cases) with MRSA-negative patients (controls) matched by age, sex, and campus.
• Social networks were constructed for all cases and controls, linking patients to rooms, roommates, and healthcare providers over time.
• A timed animation of the healthcare network was used to visualize potential transmission pathways.

Main Results:

• Traditional case-control methods showed no significant differences between cases and controls in comorbidities, length of stay, mortality, or number of contacts.
• The number of rooms and roommates significantly increased by over 50% during the outbreak period.
• Network animation identified potential source patients linked to specific rooms and numerous roommates, followed by a proliferation of cases connected to those same rooms.

Conclusions:

• Network animation over time proved more effective than traditional case-control attributes in revealing MRSA transmission pathways.
• Understanding patient movement and contact networks is essential for controlling MRSA spread in healthcare settings.
• Dynamic network visualization offers a novel approach to identifying and mitigating infectious disease transmission in hospitals.