Competition of hospital-acquired and community-acquired methicillin-resistant Staphylococcus aureus strains in hospitals.
Competition of hospital-acquired and community-acquired methicillin-resistant Staphylococcus aureus strains in hospitals.
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DOI：
10.1080/17513750903026411
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发表时间：
2010-01
影响因子：
2.8
通讯作者：
Ruan S
中科院分区：
文献类型：
--
作者：
Webb GF;Horn MA;D'Agata EM;Moellering RC Jr;Ruan S
最近，我们[E.M.C.] D'Agata，G.F. Webb，文学硕士霍恩小默勒林，和S.阮，社区获得性耐甲氧西林金黄色葡萄球菌侵入医院环境的模型，临床感染。48（2009），pp. 274-284]提出了一种确定性数学模型来表征导致社区获得性MRSA（CA-MRSA）取代医院获得性耐甲氧西林金黄色葡萄球菌（HA-MRSA）的因素，并量化旨在限制CA-MRSA在医院环境中传播的干预措施的有效性。该模型的数值模拟强烈表明，CA-MRSA将成为医院环境中的主要MRSA菌株。在本文中，我们提供了稳态分析和更多的数值模拟模型。研究表明，当没有定植或感染的患者进入医院时，CA-MRSA将竞争性排除HA-MRSA，CA-MRSA感染的严重程度增加，导致住院时间延长和CA-MRSA的院内储存量增加。提高手部卫生依从性和CA-MRSA携带者的非殖民化是有效的控制策略。
Recently, we [E.M.C. D’Agata, G.F. Webb, M.A. Horn, R.C. Moellering Jr., and S. Ruan, Modelling the invasion of community-acquired methicillin-resistant Staphylococcus aureus into the hospital setting, Clin. Infect. Dis. 48 (2009), pp. 274–284] proposed a deterministic mathematical model to characterize the factors contributing to the replacement of hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) with the community-acquired MRSA (CA-MRSA) and to quantify the effectiveness of interventions aimed at limiting the spread of CA-MRSA in the hospital setting. Numerical simulations of the model strongly suggest that CA-MRSA will become the dominant MRSA strain in the hospital setting. In this companion paper, we provide steady-state analysis and more numerical simulations of the model. It is shown that when no colonized or infected patients enter the hospital, competitive exclusion of HA-MRSA by CA-MRSA will occur with increased severity of CA-MRSA infections resulting in longer hospitalizations and a larger in-hospital reservoir of CA-MRSA. Improving compliance with hand hygiene and decolonization of CA-MRSA carriers are effective control strategies.