{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:25:59Z","timestamp":1789539959807,"version":"build-2803163510"},"reference-count":39,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X25000868_as1\">\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Interfacility patient transfers contribute to the regional spread of multidrug-resistant organisms (MDROs). We evaluated whether transfer patterns of inpatients with similar characteristics to carbapenem-resistant Enterobacterales (CRE) case-patients (CRE surrogates) better reflect hospital-level CRE burden than traditionally used populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25000868_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We determined the risk factors for subsequent hospital admission using demographic and clinical information from Tennessee Department of Health tracked CRE case-patients from July 2015 to September 2019. Risk factors were used to identify CRE surrogates among inpatients in the 2018 Tennessee Hospital Discharge Data System (HDDS). Transfer networks of CRE surrogates, Medicare\/TennCare beneficiaries, and all-inpatients with \u2264365 days of intervening community stays were compared with the transfer networks of CRE case-patients in 2019. The associations between hospital-level CRE prevalence and hospitals\u2019 incoming transfer volumes from each network were assessed using negative binomial regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25000868_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eight risk factors for subsequent hospital admission were identified from 2,518 CRE case-patients, which were used to match CRE case-patients with HDDS inpatients, resulting in 10,069 surrogate patients. CRE surrogate network showed more structural similarities with the CRE case-patient network than with the all-inpatient and Medicare\/TennCare networks. A 33% increase in hospitals\u2019 CRE prevalence in 2019 was associated with each doubling of incoming transfer of CRE surrogates in 2018 (adjusted Risk Ratio [aRR] 1.33, 95%CI: 1.1, 1.59), higher than all-inpatient (aRR 1.27, 95% CI: 1.08, 1.51) and Medicare\/TennCare networks (aRR 1.21, 95% CI: 1.02, 1.44).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25000868_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Surrogate transfer patterns were associated with hospital-level CRE prevalence, highlighting their value in MDRO containment and prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2025.86","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T05:57:51Z","timestamp":1750658271000},"page":"1110-1118","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Improving containment and prevention strategies using a patient transfer network representative of patients with multidrug-resistant organisms"],"prefix":"10.1017","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5425-3201","authenticated-orcid":false,"given":"Rany","family":"Octaria","sequence":"first","affiliation":[{"name":"Vanderbilt University Graduate School"},{"name":"Tennessee Department of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Deppen","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Chan","sequence":"additional","affiliation":[{"name":"Tennessee Department of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Slaughter","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3747-3739","authenticated-orcid":false,"given":"Pamela","family":"Talley","sequence":"additional","affiliation":[{"name":"Tennessee Department of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4699-8040","authenticated-orcid":false,"given":"Rachel B.","family":"Slayton","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1951-9104","authenticated-orcid":false,"given":"Peter F.","family":"Rebeiro","sequence":"additional","affiliation":[{"name":"Vanderbilt University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7678-8744","authenticated-orcid":false,"given":"Marion A.","family":"Kainer","sequence":"additional","affiliation":[{"name":"Tennessee Department of Health"},{"name":"Vanderbilt University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"S0899823X25000868_ref29","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy084"},{"key":"S0899823X25000868_ref23","unstructured":"23. Interpreting Log Transformations in a Linear Model | University of Virginia Library Research Data Services + Sciences. Accessed May 13, 2022. https:\/\/data.library.virginia.edu\/interpreting-log-transformations-in-a-linear-model\/"},{"key":"S0899823X25000868_ref6","doi-asserted-by":"publisher","DOI":"10.3201\/eid2609.190592"},{"key":"S0899823X25000868_ref18","unstructured":"18. Council of State and Territorial Epidemiologists. Change in Case Definition from Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) to Carbapenemase-Producing Organisms (CPO), 2017. https:\/\/cdn.ymaws.com\/www.cste.org\/resource\/resmgr\/ps\/ps2022\/22-ID-04_CPO.pdf"},{"key":"S0899823X25000868_ref15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12480"},{"key":"S0899823X25000868_ref32","first-page":"s120","article-title":"An interactive patient transfer network and model visualization tool for multidrug-resistant organism prevention strategies","volume":"3","author":"Octaria","year":"2023","journal-title":"Antimicrob Steward Healthc Epidemiol ASHE"},{"key":"S0899823X25000868_ref7","doi-asserted-by":"publisher","DOI":"10.1086\/662375"},{"key":"S0899823X25000868_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13135"},{"key":"S0899823X25000868_ref11","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz154"},{"key":"S0899823X25000868_ref21","unstructured":"21. 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Centers for Disease Control and Prevention. Public Health Strategies to Prevent the Spread of Novel and Targeted Multidrug-resistant Organisms (MDROs). 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}