Rapid Emergence of Co-colonization with Community-acquired and Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Strains in the Hospital Setting

E. M. C. D’Agata; G. F. Webb; J. Pressley

Mathematical Modelling of Natural Phenomena (2010)

  • Volume: 5, Issue: 3, page 76-93
  • ISSN: 0973-5348

Abstract

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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 strainsResults: The model analysis shows that the state of co-colonization becomes endemic over time and that typically 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.

How to cite

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D’Agata, E. M. C., Webb, G. F., and Pressley, J.. "Rapid Emergence of Co-colonization with Community-acquired and Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Strains in the Hospital Setting." Mathematical Modelling of Natural Phenomena 5.3 (2010): 76-93. <http://eudml.org/doc/197712>.

@article{D2010,
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 strainsResults: The model analysis shows that the state of co-colonization becomes endemic over time and that typically 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.},
author = {D’Agata, E. M. C., Webb, G. F., Pressley, J.},
journal = {Mathematical Modelling of Natural Phenomena},
keywords = {methicillin-resistance; Staphylococcus aureus; community; hospital; co-colonization; staphylococcus aureus; ordinary differential equations},
language = {eng},
month = {4},
number = {3},
pages = {76-93},
publisher = {EDP Sciences},
title = {Rapid Emergence of Co-colonization with Community-acquired and Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Strains in the Hospital Setting},
url = {http://eudml.org/doc/197712},
volume = {5},
year = {2010},
}

TY - JOUR
AU - D’Agata, E. M. C.
AU - Webb, G. F.
AU - Pressley, J.
TI - Rapid Emergence of Co-colonization with Community-acquired and Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Strains in the Hospital Setting
JO - Mathematical Modelling of Natural Phenomena
DA - 2010/4//
PB - EDP Sciences
VL - 5
IS - 3
SP - 76
EP - 93
AB - 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 strainsResults: The model analysis shows that the state of co-colonization becomes endemic over time and that typically 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.
LA - eng
KW - methicillin-resistance; Staphylococcus aureus; community; hospital; co-colonization; staphylococcus aureus; ordinary differential equations
UR - http://eudml.org/doc/197712
ER -

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