Modeling of Antibiotic Resistance in the ICU
Modeling of Antibiotic Resistance in the ICU
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DOI：
10.1007/978-1-4615-0781-9_18
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
M. Lipsitch;Carl T. Bergstrom
中科院分区：
文献类型：
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作者：
M. Lipsitch;Carl T. Bergstrom
数学模型是预测和解释医院感染流行病学的宝贵工具。因此，建模将在控制医院中抗生素耐药细菌日益严重的威胁方面发挥至关重要的作用。在本章中，我们使用医院环境中抗生素敏感和耐药细菌的定植和感染的简单数学模型来说明基于模型的方法的实用性。该模型解释了有关医院耐药性传播的许多违反直觉的观察结果：（1）洗手等非特异性感染控制措施将不成比例地降低医院内耐药菌的流行率； (2) 抵抗控制干预措施在医院中比在整个社区中更快地减少抵抗力； (3) 即使不存在遗传相关的耐药机制，使用一种抗生素治疗也可能是获得另一种抗生素耐药性的个体危险因素。
Mathematical models are valuable tools with which to predict and explain the epidemiology of nosocomial infection. As such, modeling will play a crucial role in the effort to control the growing threat posed in hospitals by antibiotic-resistant bacteria. In this chapter, we illustrate the utility of the model-based approach, using a simple mathematical model of colonization and infection by antibiotic-sensitive and resistant bacteria in a hospital setting. The model explains a number of otherwise counterintuitive observations regarding the spread of nosocomial resistance: (1) nonspecific infection control measures such as hand-washing will disproportionately reduce the prevalence of resistant bacteria within the hospital; (2) resistance-control interventions should generate reductions in resistance much more rapidly in hospitals than in communities as a whole; (3) treatment with one antibiotic may be an individual risk factor for acquisition of resistance to another antibiotic, even in the absence of genetically linked resistance mechanisms.