Mathematical model of the impact of a nonantibiotic treatment for Clostridium difficile on the endemic prevalence of vancomycin-resistant enterococci in a hospital setting

DOI10.1155/2012/605861MaRDI QIDQ764186zbMATH OpenOpenAlexWikidataFDO

Authors Daniel T. Grima, E. M. C. D'Agata, Glenn Webb

Publication date 13 March 2012

Published in Computational \& Mathematical Methods in Medicine (Search for Journal in Brave)

Full work available at URL https://doi.org/10.1155/2012/605861

Mathematics Subject Classification ID

Medical applications (general) (92C50)

Review text

Summary: Clostridium difficile-associated disease (CDAD) is treated using antibiotics, which often leads to the emergence of antibiotic-resistant bacteria, such as vancomycin-resistant enterococci (VRE). This study estimated the impact of a non-antibiotic treatment for CDAD on VRE prevalence. A previously published model describing the impact of in-hospital antibiotic use on VRE prevalence was adapted to include CDAD treatment. Simulations compared the prevalence of VRE when nonantibiotic versus antibiotic therapy were used. Nonantibiotic treatment in 50\% of CDAD patients resulted in an 18\% relative reduction in the prevalence of VRE colonization compared with antibiotic use only. Sensitivity analysis found the model to be most sensitive to rates of antibiotic initiation and discontinuation, prevalence of VRE in admitted patients, length of stay of colonized patients, probability of CDAD acquisition, and hand-washing compliance. Nonantibiotic treatment of patients hospitalized with CDAD may significantly reduce the incidence of VRE colonization.

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• Mathematical modelling reveals properties of tcdc required for it to be a negative regulator of toxin production in \textit{clostridium difficile}
• Optimal control of vancomycin-resistant enterococci using preventive care and treatment of infections
• Stationary solution of a stochastic nosocomial epidemic model in hospital intensive care units
• Vancomycin-resistant enterococci colonization-infection model: parameter impacts and outbreak risks
• Individual based models and differential equations models of nosocomial epidemics in hospital intensive care units
• The work of Glenn F. Webb

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