Distribution of strain types and colonization or infection status in the patient population.

<p>The fraction of patients in the hospital colonized, colonized with a resistant strain (R), colonized with a non-resistant strain (NR) and colonized with both resistant and non-resistant strains (R+NR), at the end of each day, averaged over 500 simulations.</p

An Individual-Based Model of Transmission of Resistant Bacteria in a Veterinary Teaching Hospital

<div><p>Veterinary nosocomial infections caused by antibiotic resistant bacteria cause increased morbidity, higher cost and length of treatment and increased zoonotic risk because of the difficulty in treating them. In this study, an individual-based model was developed to investigate the effects of movements of canine patients among ten areas (transmission points) within a veterinary teaching hospital, and the effects of these movements on transmission of antibiotic susceptible and resistant pathogens. The model simulates contamination of transmission points, healthcare workers, and patients as well as the effects of decontamination of transmission points, disinfection of healthcare workers, and antibiotic treatments of canine patients. The model was parameterized using data obtained from hospital records, information obtained by interviews with hospital staff, and the published literature. The model suggested that transmission resulting from contact with healthcare workers was common, and that certain transmission points (housing wards, diagnostics room, and the intensive care unit) presented higher risk for transmission than others (lobby and surgery). Sensitivity analyses using a range of parameter values demonstrated that the risk of acquisition of colonization by resistant pathogens decreased with shorter patient hospital stays (<i>P</i><0.0001), more frequent decontamination of transmission points and disinfection of healthcare workers (<i>P</i><0.0001) and better compliance of healthcare workers with hygiene practices (<i>P</i><0.0001). More frequent decontamination of heavily trafficked transmission points was especially effective at reducing transmission of the model pathogen.</p></div

The yearly average of fraction of time that the transmission points remain contaminated.

<p>The yearly average of fraction of time each transmission point remains contaminated, averaged further over 500 simulations. Bars represent standard deviation across the yearly averages of 500 simulations.</p

Patient movement inside the hospital.

<p>Patients seen for regular exams (yellow) are limited to the lobby, diagnostics and radiology. Patients seen for non-surgical problems (vertical lines) may be housed in wards or in the ICU and are taken outside for walks. Patients coming to WSU VTH for surgery (horizontal lines) have additional movements to the induction, surgery and recovery rooms.</p

Environmental survey results.

a<p>Each location was visited a total of 12 times with 5 samples collected at each visit for a total of 30 samples during the day and 30 during the night.</p>b<p>Day includes the hours between 8 AM and 8 PM. Night includes the hours between 8:00 PM and 8:00 AM. Samples were collected at 2-hour intervals.</p>c<p>Fisher exact <i>P</i>-value for the difference in proportion between day and night.</p>d<p><i>P</i>-value for difference between four mean proportions  = 0.71.</p>e<p><i>P</i>-value for difference between four mean proportions  = 0.44.</p

Type III statistical test results for analysing the significance of various parameters on the mean fraction of the patient population carrying the resistant strain of the potential pathogen.

a<p>Average length of stay of hospitalized patients.</p>b<p>Rate at which infections are detected.</p>c<p>Efficiency of disinfection/decontamination of healthcare worker and transmission points.</p>d<p>Average time before disinfection/decontamination of contaminated healthcare worker and transmission point.</p>e<p>Probability of colonization of patient given contact with contaminated healthcare workers and transmission points.</p>f<p>Number of days after the initial antibiotic therapy that the effective antibiotic therapy starts.</p>g<p>Number of healthcare workers inside the hospital at any given time.</p

Variations in model parameters.

<p>HCW- healthcare worker, TP- transmission point.</p

List of parameters and their baseline values.

<p>*values for the WSU VTH were based on information from the hospital staff.</p><p>**values used by D'Agata et. al, 2007 <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0098589#pone.0098589-DAgata2" target="_blank">[26]</a>, in the IBM for human patients.</p><p>***values estimated in this study using the hospital records and surveillance data.</p><p>HCW- healthcare worker, TP- transmission point.</p

Percentage contamination with <i>Enterococci</i> or ampicillin-nalidixic acid-resistant coliforms of four transmission points by time of day.

<p>The average combined contamination prevalence of the four places sampled during the validation survey: the exam rooms, the diagnostics, ICU and the housing wards, at different times the sampling was done. Each data point is the average percentage contamination in 20 samples (5 samples per location) for each time. Bars represent the standard error over these 20 samples.</p

MOESM10 of Spermatid-specific linker histone HILS1 is a poor condenser of DNA and chromatin and preferentially associates with LINE-1 elements

Additional file 10: Table S7. LINE-1 subclass elements identification. Table represents the number of different types of subclasses of LINE-1 repeat elements associated with HILS1 and percentage of HILS1 occupancy to each subclass with respect to the total number of each in the rat genome