MedicalResearch.com Interview with:
Bruce Y. Lee, MD MBA
Associate Professor of International Health
Director of Operations Research
International Vaccine Access Center (IVAC)
Johns Hopkins Bloomberg School of Public Health
855 N. Wolfe Street Suite 600
Baltimore, MD 21205
MedicalResearch.com: What are the main findings of the study?
Dr. Lee: Vancomycin resistant enterococci (VRE) is every hospital’s problem. A VRE outbreak in one hospital, even if the hospital is relatively small or distant, can readily spread to other hospitals in a region because patients leaving one hospital often will go to other hospitals either directly or after an intervening stay at home. These patients can then carry VRE with them to other hospitals. Therefore, as long a single hospital has a problem with VRE or any other healthcare associated infection, all other hospitals are at risk. Conquering VRE then requires cooperation among hospitals.
MedicalResearch.com: Were any of the findings unexpected?
Dr. Lee: It is striking how many other hospitals in a county are affected by a VRE outbreak in a single hospital, again even if the hospital is relatively small and seemingly isolated. In many cases, an outbreak will affect all of the hospitals in a county to some degree. Also, pinpointing the origin of a VRE outbreak can be challenging. An outbreak in one hospital could actually be the continuation of an outbreak from other hospitals. Additionally, the effects of a hospital having an increase in VRE can occur gradually with the total impact not fully manifesting until months or even years later.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Lee: With the increase in popularity of hospital rankings and reports, patients and clinicians may think that as long as their hospital ranks well on infection control and other similar measures that they do not have to think about other hospitals in the region. They may read about another hospital in their city, county, or region having poor infection control or a VRE outbreak and think, “Thank goodness, it is not my hospital” or “that won’t affect me.” However, such thoughts are misleading. Patients and clinicians have to worry about other hospitals because everyone is connected. They need to push for more sharing of infection control information among different hospitals and with the public. They should be aware of VRE and any other pathogen that may affect any hospital or patient their area and also advocate for better control measures everywhere.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Lee: It would be helpful to identify, test, and implement ways to stimulate greater awareness of infection control measures throughout a region and cooperation among hospitals and infection control specialists. This may be through changes in regulations, reimbursements, financial incentives, reporting, surveillance measures, infection control measures, and communication.
Modeling the regional spread and control of vancomycin-resistant enterococci
August 2013(Vol. 41 | No. 8 | Pages 668-673)
Bruce Y. Lee, S. Levent Yilmaz, Kim F. Wong, Sarah M. Bartsch, Stephen Eubank, Yeohan Song, Taliser R. Avery, Richard Christie, Shawn T. Brown, Joshua M. Epstein, Jon I. Parker, Susan S. Huang