Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-10T13:46:41.277Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baba, T., Takeuchi, F., Kuroda, M., Yuzawa, H., Aoki, K., Oguchi, A., Nagai, Y., Iwama, N., Asano, K. Naimi, T.. Genome and virulence determinants of high virulence community-acquired MRSA . Lancet, 359 (2002), No. 9320, 1819–1827.CrossRefGoogle ScholarPubMed
Bassetti, M., Nicco, E., Mikulska, M.. Why is community-associated MRSA spreading across the world and how will it change clinical practice? International Journal of Antimicrobial Agents, 34 (2009), No. S1, S15–S19. CrossRefGoogle ScholarPubMed
Cespedes, C., Saïd-Salim, B., Miller, M., Lo, S. H., Kreiswirth, B. N., Gordon, R. J., Vavagiakis, P., Klein, R. S. Lowy, F. D.. The clonality of Staphylococcus aureus nasal carriage . J. Infect. Dis., 191 (2005), 444–452.CrossRefGoogle ScholarPubMed
Coen, P. G., Wilks, M., Dall’Antonia, M. Millar, M.. Detection of multiple-strain carriers: the value of re-sampling . J. Theor. Biol., 240 (2006), No. 1, 98–103.CrossRefGoogle ScholarPubMed
Crawford, B. Kribs Zaleta, C. M.. The impact of vaccination and coinfection on HPV and cervical cancer . Discrete and Continuous Dynamical Systems Series B, 12 (2009), No. 2, 279–304.Google Scholar
D’Agata, E. M. C., Webb, G. F. Horn, M.. A mathematical model quantifying the impact of antibiotic exposure and other interventions on the endemic prevalence of vancomycin-resistant Enterococci . J. Infect. Dis., 192 (2005), 2004–2011.CrossRefGoogle ScholarPubMed
D’Agata, E. M. C., Webb, G. F., Horn, M. A., Moellering, R. C. Ruan, S.. Modeling the invasion of community-acquired methicillin-resistant Staphylococcus aureus into hospitals . Clin. Infect. Dis., 48 (2009), No. 3, 274–284.CrossRefGoogle Scholar
Davis, S. L., Rybak, M. J., Amjad, M., Kaatz, G. W. McKinnon, P. S.. Characteristics of patients with healthcare-associated infection due of SCCmec Type IV methcillin-resistant Staphylococcus aureus . Infect. Control Hosp. Epidemiol., 27 (2006), 1025–1031.CrossRefGoogle Scholar
Diekema, D. J. Climo, M.. Preventing MRSA infections: finding it is not enough . JAMA, 299 (2008), No. 10, 1190–1192.CrossRefGoogle ScholarPubMed
Diep, B. A., Chambers, H. F., Graber, C. J., Szumowski, J. D., Miller, L. G., Han, L. L., Chen, J. H., Lin, F., Lin, J., Phan, T. H., Carleton, H. A., McDougal, L. K., Tenover, F. C., Cohen, D. E., Mayer, K. H., Sensabaugh, G. F. Perdreau-Remington, F.. Emergence of multidrug-resistant, community-associated methicillin-resistant Staphylococcus aureus clone USA300 in men who have sex with men . Ann. Intern. Med., 148 (2008), No. 4, 249–257.CrossRefGoogle ScholarPubMed
Herold, B. C., Immergluck, L. C., Maranan, L. C., Lauderdale, D., Gaskin, R., Boyle-Vavra, S., Leitch, C. D. Daum, R. S.. Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk . JAMA, 279 (1998), No. 8, 593–508.CrossRefGoogle ScholarPubMed
Hidron, A. I., Kourbatova, E. V., Halvosa, J. S., Terrell, B. J., McDougal, L. K., Tenover, H. M. King, M. D.. Risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to an urban hospital: emergence of community-associated MRSA nasal carriage . Clin. Infect. Dis., 15 (2005), 159–166.CrossRefGoogle Scholar
Jarvis, W. R., Schlosser, J., Chinn, R. Y., Tweeten, S. Jackson, M.. National prevalence of methicillin-resistant Staphylococcus aureus in inpatients at US health care facilities . Am. J. Infect. Control, 35 (2007), No. 10, 631–637.CrossRefGoogle ScholarPubMed
Kajita, E., Okano, J. T., Bodine, E. N., Layne, S. P. Blower, S.. Modelling an outbreak of an emerging pathogen . Nat. Rev. Microbiol., 5 (2007), 700–709.CrossRefGoogle ScholarPubMed
Klevens, R. M., Morrison, M. A., Nadle, J., Petit, S., Gershman, K., Ray, S., Harrison, M., Lynfield, R., Dumyati, G., Townes, J. M., Craig, A. S., Zell, E. R., Fosheim, G. E., McDougal, L. K., Carey, R. B. Fridkin, S. K.. Invasive methicillin-resistant Staphylococcus aureus infections in the United States . JAMA, 298 (2007), 1763–1771.CrossRefGoogle ScholarPubMed
Lautenbach, E., Tolomeo, P., Black, N. Maslow, J.. Risk factors for fecal colonization with multiple distinct strains of Escherichia coli among long-term care facility residents . Infect. Control Hosp. Epidemiol., 30 (2009), 491–493.CrossRefGoogle ScholarPubMed
Li, J., Zhien, M., Blythe, S. P. Castillo-Chavez, C.. Coexistence of pathogens in sexually-transmitted disease models . J. Math. Biol., 47 (2003), No. 6, 547–568.CrossRefGoogle ScholarPubMed
McBryde, E. S., Pettitt, A. N. S. McElwain, D. L.. A stochastic mathematical model of methicillin resistant Staphylococcus aureus transmission in an intensive care unit: predicting the impact of interventions . J. Theor. Biol., 245 (2007), No. 3, 470–481.CrossRefGoogle Scholar
Miller, L. G., Perdreau-Remington, F., Rieg, G., Mehdi, S., Perlroth, J., Bayer, A. S., Tang, A. W., Phung, T. O. Spellberg, B.. Necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus in Los Angeles . New Engl. J. Med., 352 (2005), No. 14, 1445–1453.CrossRefGoogle ScholarPubMed
Okuma, K., Iwakawa, K., Turnidge, J. D., Grubb, W. B., Bell, J. M., O’Brien, F. G., Coombs, G. W., Pearman, J. W., Tenover, F. C., Kapi, M., Tiensasitorn, C., Ito, T. Hiramatsu, K.. Dissemination of new methicillin-resistant Staphylococcus aureus clones in the community . J. Clin. Microbiol., 40 (2002), No. 11, 4289–4294.CrossRefGoogle Scholar
Patel, M., Waites, K. B., Hoesley, C. J., Stamm, A. M., Canupp, K. C. Moser, S. A. Emergence of USA 300 MRSA in a tertiary medical centre: implications for epidemiological studies . J. Hosp. Infect., 68 (2008), No. 3, 208–213.CrossRefGoogle Scholar
Popovich, K. J., Weinstein, R. A., Hota, B.. Are community-associated methicillin-resistant Staphylococcus aureus (MRSA) strains replacing traditional nosocomial MRSA strains? Clin. Infect. Dis., 46 (2008), 787–794. CrossRefGoogle ScholarPubMed
J. Pressley, E. M. C. D’Agata, G. F. Webb. The effect of co-colonization with community-acquired and hospital-acquired methicillin-resistant Staphylococcus aureus strains on competitive exclusion. J. Theor. Biol., (2010), to appear.
Seybold, U., Kourbatova, E. V., Johnson, J. G., Halvosa, S. J., Wang, Y. F., King, M. D., Ray, S. M. Blumberg, H. M.. Emergence of community-associated methicillin-resistant Staphylococcus aureus USA 300 genotype as a major cause of health care-associated blood stream infections . Clin. Infect. Dis., 42 (2006), 647–666.CrossRefGoogle Scholar
Tristan, A., Bes, M., Meugnier, H., Lina, G., Bozdogan, B., Courvalin, P., Reverdy, M., Enright, M., Vandenesch, F. Etienne, J.. Global distribution of Panton-Valentine Leukocidin-positive methicillin-resistant Staphylococcus aureus . Emerg. Infect. Dis., 13 (2007), No. 4, 594–600.CrossRefGoogle ScholarPubMed
Wertheim, H. F., Verveer, J., Boelens, H. A., Belkum, van A., Verbrugh, H. A. Vos, M. C.. Effect of mupirocin treatment on nasal, pharyngeal, and perineal carriage of Staphylococcus aureus in healthy adults . Antimicrob. Agents Chemother., 49 (2005), No. 4, 1465–1467.CrossRefGoogle ScholarPubMed
Xiridou, M., Borkent-Raven, B., Hulshof, J. Wallinga, J.. How hepatitis D virus can hinder the control of hepatitis B virus . PLoS ONE, 4 (2009), 4.CrossRefGoogle Scholar