Rapid emergence of co-colonization with community-acquired and hospital-acquired methicillin-resistant staphylococcus aureus strains in the hospital setting
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Publication:3562963
ordinary differential equationscommunitystaphylococcus aureushospitalco-colonizationmethicillin-resistance
Applications of statistics to biology and medical sciences; meta analysis (62P10) Medical applications (general) (92C50) Dynamical systems in biology (37N25) Applications of functional analysis in biology and other sciences (46N60) Applications of boundary value problems involving ordinary differential equations (34B60)
Abstract: Background: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), a novel strain of MRSA, has recently emerged and rapidly spread in the community. Invasion into the hospital setting with replacement of the hospital-acquired MRSA (HA-MRSA) has also been documented. Co-colonization with both CA-MRSA and HA-MRSA would have important clinical implications given differences in antimicrobial susceptibility profiles and the potential for exchange of genetic information. Methods: A deterministic mathematical model was developed to characterize the transmission dynamics of HA-MRSA and CA-MRSA in the hospital setting and to quantify the emergence of co-colonization with both strains. Results: The model analysis shows that the state of co-colonization becomes endemic over time and that there is no competitive exclusion of either strain. Increasing the length of stay or rate of hospital entry among patients colonized with CA-MRSA leads to a rapid increase in the co-colonized state. Compared to MRSA decolonization strategy, improving hand hygiene compliance has the greatest impact on decreasing the prevalence of HA-MRSA, CA-MRSA and the co-colonized state. Conclusions: The model predicts that with the expanding community reservoir of CA-MRSA, the majority of hospitalized patients will become colonized with both CA-MRSA and HA-MRSA.
Recommendations
- Competition of hospital-acquired and community-acquired methicillin-resistantStaphylococcus aureusstrains in hospitals
- The effect of co-colonization with community-acquired and hospital-acquired methicillin-resistant \textit{Staphylococcus aureus} strains on competitive exclusion
- Modeling of Community- and Hospital-acquired Methicillin-resistant Staphylococcus Aureus Transmission in Hospital Settings
- Optimal control of methicillin-resistant \textit{Staphylococcus aureus} transmission in hospital settings
- A stochastic mathematical model of methicillin resistant \textit{Staphylococcus aureus} transmission in an intensive care unit: predicting the impact of interventions
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