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Rapid Emergence of Co-colonization with Community-acquired andHospital-Acquired Methicillin-Resistant Staphylococcus aureus Strains inthe Hospital Setting

Published online by Cambridge University Press:  28 April 2010

E. M. C. D’Agata ,
G. F. Webb  and
J. Pressley
E. M. C. D’Agata*
Affiliation:
Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
G. F. Webb
Affiliation:
Department of Mathematics, Vanderbilt University, Nashville, TN 37240, USA
J. Pressley
Affiliation:
Department of Mathematics, Vanderbilt University, Nashville, TN 37240, USA
*
*Corresponding author. E-mail:edagata@bidmc.harvard.edu
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Abstract

Background: Community-acquired methicillin-resistant Staphylococcusaureus (CA-MRSA), a novel strain of MRSA, has recently emerged and rapidlyspread in the community. Invasion into the hospital setting with replacement of thehospital-acquired MRSA (HA-MRSA) has also been documented. Co-colonization with bothCA-MRSA and HA-MRSA would have important clinical implications given differences inantimicrobial susceptibility profiles and the potential for exchange of geneticinformation.

Methods: A deterministic mathematical model was developed to characterizethe transmission dynamics of HA-MRSA and CA-MRSA in the hospital setting and to quantifythe emergence of co-colonization with both strains

Results: The model analysis shows that the state of co-colonization becomesendemic 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 withCA-MRSA leads to a rapid increase in the co-colonized state. Compared to MRSAdecolonization strategy, improving hand hygiene compliance has the greatest impact ondecreasing the prevalence of HA-MRSA, CA-MRSA and the co-colonized state.

Conclusions: The model predicts that with the expanding community reservoirof CA-MRSA, the majority of hospitalized patients will become colonized with both CA-MRSAand HA-MRSA.

Keywords

methicillin-resistanceStaphylococcus aureuscommunityhospitalco-colonization
Type
Research Article
Information
Mathematical Modelling of Natural Phenomena , Volume 5 , Issue 3: Mathematical modeling in the medical sciences , 2010 , pp. 76 - 93
Copyright
© EDP Sciences, 2010

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