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Abstract Healthcare-associated infections (HAIs) are a major problem in hospital infection control. Although HAIs can be suppressed using contact precautions, such precautions are expensive, and we can only apply them to a small fraction of patients (i.e., a limited budget). In this work, we focus on two clinical problems arising from the limited budget: (a) choosing the best patients to be placed under precaution given a limited budget to minimize the spread (the isolation problem), and (b) choosing the best patients to release when limited budget requires some of the patients to be cleared from precaution (the clearance problem). A critical challenge in addressing them is that HAIs have multiple transmission pathways such that locations can also accumulate ‘load’ and spread the disease. One of the most common practices when placing patients under contact precautions is the regular clearance of pathogen loads. However, standard propagation models like independent cascade (IC)/susceptible-infectious-susceptible (SIS) cannot capture such mechanisms directly. Hence to account for this challenge, using non-linear system theory, we develop a novel spectral characterization of a recently proposed pathogen load based model,2-Mode-SISmodel, on people/location networks to capture spread dynamics of HAIs. We formulate the two clinical problems using this spectral characterization and develop effective and efficient algorithms for them. Our experiments show that our methods outperform several natural structural and clinical approaches on real-world hospital testbeds and pick meaningful solutions.
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Detecting Sources of Healthcare Associated Infections
Healthcare acquired infections (HAIs) (e.g., Methicillin-resistant Staphylococcus aureus infection) have complex transmission pathways, spreading not just via direct person-to-person contacts, but also via contaminated surfaces. Prior work in mathematical epidemiology has led to a class of models – which we call load sharing models – that provide a discrete-time, stochastic formalization of HAI-spread on temporal contact networks. The focus of this paper is the source detection problem for the load sharing model. The source detection problem has been studied extensively in SEIR type models, but this prior work does not apply to load sharing models.We show that a natural formulation of the source detection problem for the load sharing model is computationally hard, even to approximate. We then present two alternate formulations that are much more tractable. The tractability of our problems depends crucially on the submodularity of the expected number of infections as a function of the source set. Prior techniques for showing submodularity, such as the "live graph" technique are not applicable for the load sharing model and our key technical contribution is to use a more sophisticated "coupling" technique to show the submodularity result. We propose algorithms for our two problem formulations by extending existing algorithmic results from submodular optimization and combining these with an expectation propagation heuristic for the load sharing model that leads to orders-of-magnitude speedup. We present experimental results on temporal contact networks based on fine-grained EMR data from three different hospitals. Our results on synthetic outbreaks on these networks show that our algorithms outperform baselines by up to 5.97 times. Furthermore, case studies based on hospital outbreaks of Clostridioides difficile infection show that our algorithms identify clinically meaningful sources.
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- PAR ID:
- 10430064
- Date Published:
- Journal Name:
- Proceedings of the AAAI Conference on Artificial Intelligence
- Volume:
- 37
- Issue:
- 4
- ISSN:
- 2159-5399
- Page Range / eLocation ID:
- 4347 to 4355
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1609/aaai.v37i4.25554
