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MRSA linked to referrals between hospitals

Taking high numbers of patient referrals may raise a hospital's MRSA rate

OnMedica staff

Friday, 19 March 2010

It is unfair to assume that a hospital’s rate of hospital-acquired infection necessarily reflects its standards of health care and hygiene, say researchers in the Netherlands.

Their study, published today in the open-access journal PLoS Computational Biology, shows that referred patients are more likely to be admitted to university medical centres than to teaching or general hospitals. Because each referred patient has the potential to bring with them a hospital-acquired infection such as MRSA, university hospitals taking a large number of patient referrals from other hospitals may have higher infection rates.

The authors, from the University Medical Center Groningen and the University Medical Center Utrecht, gathered patient admissions data from the National Medical Registry which they used to reconstruct the entire hospital network of the Netherlands. They found from these data that university medical centres admitted more patients who had recently stayed in other hospitals. They say this means that university medical centres are more likely to admit patients who still carry pathogens acquired during previous hospital visits, thus raising their own rates of hospital-acquired infections.

The research shows that this difference in ‘connectedness’ within the hospital network leads to differences in prevalence of hospital-acquired infections. As a consequence the authors suggest that interventions aimed at reducing rates of hospital-acquired infection should therefore focus on those hospitals that are central in the network of patient referrals.

The authors say that their methods do not account for transmission outside the hospitals. If community transmission of hospital-acquired infections were to become a significant factor, the observed effect would be diluted.

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