The inherent stochasticity in transmission of hospital-acquired infections (HAIs) has complicated our understanding of transmission pathways. It is particularly difficult to detect the impact of changes in the environment on the acquisition rate due to stochasticity. In this study, we investigated the impact of uncertainty (epistemic and aleatory) on nosocomial transmission of HAIs by evaluating the effects of stochasticity on the detectability of seasonality on admission. For doing so, we developed an agent-based model of an ICU and simulated the acquisition of HAIs considering the uncertainties in the behavior of the healthcare workers (HCWs) and transmission of pathogens between patients, HCWs, and the environment. Our results show that stochasticity in HAI transmission weakens our ability to detect the effects of a change, such as seasonality, on the acquisition rate, particularly when transmission is a low-probability event. In addition, our findings demonstrate that data compilation can address this issue, while the amount of required data depends on the size of the said change and the amount of stochasticity. Our methodology can be used as a framework to assess the impact of interventions and provide decision-makers with insight about the minimum required size and target of interventions in a healthcare facility.

No dataset was used in the paper. The Python code for the ABM is provided. For deatils of the code, please refer to the README document (README.md), and for the details of the methodology, please refer to the manuscript. [Manuscript currently under review by Royal Society Open Science]

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