Inferring heterogeneous transmission and community introduction of antibiotic-resistant bacteria in hospital settings

The article addresses the problem of antibiotic-resistant microorganisms in hospitals, which represent a major burden on healthcare systems. Researchers developed a new method called BAIF (blockwise agent-based iterated filter) to analyze the transmission of these bacteria between patients across different hospital wards. The method accounts for patient movement between wards, asymptomatic carriage, and imperfect diagnostic sensitivity. Synthetic experiments confirmed that BAIF can detect transmission parameters from partially observed outbreaks. Researchers applied their framework to data from a New York hospital from 2012 to 2016 for four types of antibiotic-resistant bacteria. They found that transmission and introduction of bacteria were highly heterogeneous across individual wards. Elevated transmission was repeatedly concentrated in the same ward groups, while wards with the highest importation varied by pathogen type.