Antimicrobial resistance (AMR) is an urgent public health threat causing an estimated 2,868,700 infections and 35,900 deaths each year in the United States. Multi drug-resistant organisms (MDROs), including carbapenem-resistant Enterobacteriaceae (CRE), Methicillin-resistant Staphylococcus aureus (MRSA) and organisms related to antimicrobial drug use and resistance such as Clostridioides difficile, often are the causative agents in healthcare-associated infections. Studies show that these pathogens can colonize patients for extended periods of time. One study found that 38% of patients colonized with CRE were still colonized even a year after discharge from a facility; such patients can serve as reservoirs for MDROs in the community or in healthcare facilities.
A mathematical modeling study found that facility-level infection prevention measures alone are insufficient to prevent transmission. A coordinated approach to contain MDROs among interconnected healthcare facilities and public health reduced acquisition by 74% in a small network model over 5 years and 55% in a large network over 15 years.
Despite numerous research publications on the role patient-sharing networks play in addressing MDRO transmission, few address the application of these networks in public health practice. Until now! A recent study conducted at Vanderbilt University Graduate School in Nashville, Tennessee in partnership with the CDC and others, constructed networks among hospitals and skilled nursing facilities that allow the participant to visualize the facility of interest with its connected facilities that receive or send patients, the number of interfacility transfers and facilities at risk of receiving a transfer from the facility of interest.
This tool is a web-based application for real-time, easy access with internet browsers from computer desktops or handheld devices. This flexibility ensures public health staff can access the application to identify at-risk facilities in a variety of settings, such as when in the field performing point prevalence surveys or during routine office work. The application has helped epidemiologists and infection preventionists prioritize communication during public health containment responses.