Modeling the effect of antibiotic exposure on the transmission of methicillin-resistant Staphylococcus aureus in hospitals with environmental contamination

Qimin Huang; Mary Ann Horn; Shigui Ruan; Qimin Huang; Mary Ann Horn; Shigui Ruan

doi:10.3934/mbe.2019181

Mathematical Biosciences and Engineering

2019, Volume 16, Issue 5: 3641-3673. doi: 10.3934/mbe.2019181

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Research article

Modeling the effect of antibiotic exposure on the transmission of methicillin-resistant Staphylococcus aureus in hospitals with environmental contamination

1.
Department of Mathematics, Applied Mathematics and Statistics, Case Western Reserve University, Cleveland, OH 44106-7058, USA
2.
Department of Mathematics, University of Miami, Coral Gables, FL 33146, USA

Received: 11 February 2019 Accepted: 02 April 2019 Published: 23 April 2019

In this paper both deterministic and stochastic models are developed to explore the roles that antibiotic exposure and environmental contamination play in the spread of antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), in hospitals. Uncolonized patients without or with antibiotic exposure, colonized patients without or with antibiotic exposure, uncontaminated or contaminated healthcare workers, and free-living bacteria are included in the models. Under the assumption that there is no admission of the colonized patients, the basic reproduction number $R_0$ is calculated. It is shown that when $R_0 < 1$, the infection-free equilibrium is globally asymptotically stable; when $R_0>1$, the infection is uniformly persistent. Numerical simulations and sensitivity analysis show that environmental cleaning is a critical intervention, and hospitals should use antibiotics properly and as little as possible. The rapid and efficient treatment of colonized patients, especially those with antibiotic exposure, is key in controlling MRSA infections. Screening and isolating colonized patients at admission, and improving compliance with hand hygiene are also important control strategies.
- Methicillin-resistant Staphylococcus aureus,
- antibiotic exposure,
- environmental contamination,
- deterministic and stochastic models,
- basic reproduction number,
- persistence
Citation: Qimin Huang, Mary Ann Horn, Shigui Ruan. Modeling the effect of antibiotic exposure on the transmission of methicillin-resistant Staphylococcus aureus in hospitals with environmental contamination[J]. Mathematical Biosciences and Engineering, 2019, 16(5): 3641-3673. doi: 10.3934/mbe.2019181

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Abstract

In this paper both deterministic and stochastic models are developed to explore the roles that antibiotic exposure and environmental contamination play in the spread of antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), in hospitals. Uncolonized patients without or with antibiotic exposure, colonized patients without or with antibiotic exposure, uncontaminated or contaminated healthcare workers, and free-living bacteria are included in the models. Under the assumption that there is no admission of the colonized patients, the basic reproduction number $R_0$ is calculated. It is shown that when $R_0 < 1$, the infection-free equilibrium is globally asymptotically stable; when $R_0>1$, the infection is uniformly persistent. Numerical simulations and sensitivity analysis show that environmental cleaning is a critical intervention, and hospitals should use antibiotics properly and as little as possible. The rapid and efficient treatment of colonized patients, especially those with antibiotic exposure, is key in controlling MRSA infections. Screening and isolating colonized patients at admission, and improving compliance with hand hygiene are also important control strategies.

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