516. Social Network Analysis to Study MDRO Transmission in VA Community Living Centers and Spinal Cord Injury Units

BACKGROUND: Residents of VA Community Living Centers (CLC) and Spinal Cord Injury units (SCI) are commonly colonized or infected with multidrug-resistant organisms (MDROs). The mechanisms by which MDROs are spread between residents in CLC/SCI settings remain poorly understood. Our objective was to develop methods to better understand how MDROs are spread in VA CLCs/SCIs. METHODS: Preliminary data from two of the four VA medical centers participating in an ongoing study are included in these analyses. A structured sociometric survey was employed to collect data on interactions between residents, staff and environmental surfaces in study units. UCINET was used to construct a sociogram and calculate network characteristics (density, centrality) using responses to the surveys administered in one of the participating facilities. RESULTS: A total of 136 surveys were completed by 49 staff and 45 residents at the two VA sites. Staff reported more interactions with residents than with other staff. Residents reported more interactions with staff than with other residents, the latter tending to only occur during group activities. Sociograms generated from preliminary surveys collected at one site suggest a four-core-person social network pattern connecting two staff with two specific residents and showed that the dining room was the group setting most frequently visited by residents. Mobile computers, blood pressure cuffs/thermometers and glucometers were the equipment used most heavily during resident care activities (figure). Challenges in identifying contact patterns include recall bias and inability of some residents to identify names of individuals with whom they interacted. Residents were still able to reliably identify staff roles. CONCLUSION: This preliminary work shows heterogeneous contact patterns between persons and surfaces in VA CLCs/SCIs. Characterizing this heterogeneity and its influence on MDRO spread via this type of social network analysis is feasible in the VA CLC/SCI setting, albeit with some limitations. Next steps in our studies include adding data from two additional sites and using observation techniques supplemented with microbiological sampling of targeted environmental surfaces to further understand potential transmission patterns. [Image: see text] DISCLOSURES: All authors: No reported disclosures.