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Detailed Contact Data and the Dissemination of Staphylococcus aureus in Hospitals
Authors:Thomas Obadia  Romain Silhol  Lulla Opatowski  Laura Temime  Judith Legrand  Anne C M Thiébaut  Jean-Louis Herrmann  éric Fleury  Didier Guillemot  Pierre-Yves Bo?lle
Institution:Thomas Obadia,Romain Silhol,Lulla Opatowski,Laura Temime,Judith Legrand,Anne C. M. Thiébaut,Jean-Louis Herrmann, éric Fleury,Didier Guillemot,Pierre-Yves Bo?lle,on behalf of the I-Bird Study Group
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.
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