225261 Evaluating the role of the environment in an outbreak investigation of Acinetobacter baumannii: Application of social network analysis

Monday, November 8, 2010 : 11:20 AM - 11:35 AM

Haritha Pallam, Master of Public Health , Division of Infectious Diseases, University Of Louisville, Louisville, KY
Karen McCurley, Infection Preventionist , Infection control, Kindred Hospital Louisville, Louisville, KY
Julie Harting, PGY2 Infectious Disease Resident , Dept. of Clinical and Administrative Sciences, Sullivan University College of Pharmacy, Louisville, KY
Juanita Clay, Director of Quality Management , Kindred Health Care, Kindred Hospital Louisville, Louisville, KY
Susan B. Muldoon, PhD , Department of Epidemiology and Population Health, University of Louisville School of Public Health and Information Sciences, Louisville, KY
Timothy Weimken, MPH CIC , Division of Infectious Diseases, University Of Louisville, Louisville, KY
Julio Ramirez, Professor of Medicine and Chief of the Division of Infectious Diseases , Division of Infectious Diseases, University Of Louisville, Louisville, KY
     
Introduction: The literature indicates that outbreaks of Acinetobacter baumannii are frequently due to environmental contamination. Analysis of the role of a particular room in a healthcare setting where patients are transferred from room to room frequently is challenging. The objective of this study is to define the role of social network analysis in the evaluation of the environment during an outbreak of multi drug resistant (MDR) and extreme drug resistant (XDR)- Acinetobacter

Materials and Methods: An outbreak of Acinetobacter was identified from June – September, 2009. MDR- Acinetobacter was identified in 18 patients. XDR-Acinetobacter was identified in 26 patients. An outbreak investigation was performed. Social network analysis was applied to patient room assignments throughout the outbreak period. Sociograms and measures of centrality were calculated using UCINET software.

Results: Two components were identified in the sociogram. The number of rooms that had multiple patients in them (in-degree) ranged from 1-35. One room had an in-degree of 8, indicating it housed 8 patients with Acinetobacter during the outbreak period. All but 3 patients were in multiple rooms (out-degree) during the study period. Ten patients were in more than 5 rooms and one patient was in more than 10 rooms.

Conclusions: Application of social network analysis to an outbreak investigation allows for a clear visual depiction of patient dynamics. The analysis also allows an analytic evaluation of the potential role of the environment during an outbreak investigation.

Learning Areas:
Clinical medicine applied in public health
Environmental health sciences
Epidemiology
Public health biology

Learning Objectives:
Demonstrate new perspective of outbreak investigation by using social network analysis software. This novel technology will enhance the expertise of user and improves assessment and management of pathogenic environmental contaminants under clinical settings.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I directed collection and analysis of this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3113.0: Outbreak investigations