Modeling nosocomial transmission of carbapenem-resistant bacteria

Patient acquisition of carbapenem resistant bacteria in hospitals is a serious problem that leads to adverse outcomes for infected patients. The most common carbapenem resistance mechanism in US hospitals is a mobile gene called Klebsiella pneumoniae carbapenemase (KPC), which can move between bacterial species. Previous research has demonstrated that patient-to-patient transmission cannot fully account for all cases of KPC-positive bacterial transmission in hospital settings. The study in this paper considers environmental reservoirs as an additional source of transmission. We conduct this analysis with logistic regression and random forest models of nosocomial transmission that includes both environmental factors and clinical data. Results show that infection rates are not uniformly distributed throughout the hospital and that differences in room layout play a role. However, proximity to KPC-positive Enterobacteriaceae environmental reservoirs does not significantly correlate to patient acquisition.