Methicillin-resistant Staphylococcus aureus in hospitals and the community:: Stealth dynamics and control catastrophes
Methicillin-resistant Staphylococcus aureus in hospitals and the community:: Stealth dynamics and control catastrophes
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DOI：
10.1073/pnas.0401324101
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发表时间：
2004-07-06
影响因子：
11.1
通讯作者：
Ebrahim, S
中科院分区：
文献类型：
--
作者：
Cooper, BS;Medley, GF;Ebrahim, S
耐甲氧西林金黄色葡萄球菌（MRSA）严重威胁住院患者的健康。减少MRSA传播的努力在很大程度上取决于医院卫生和患者隔离。这些措施取得了不同程度的成功：尽管一些国家几乎消除了MRSA或基本上没有这种生物体，但其他国家尽管有严格的控制政策，但仍然出现了大幅增长。我们使用一个数学模型来说明如何通过考虑MRSA定植的医院和社区水库来解释这些增加。我们展示了干预的时机、资源提供的水平和机会联合收割机如何结合起来决定控制措施的成功或失败。我们发现，即使控制措施，能够反复防止持续的爆发，在短期内可能会导致长期控制失败，造成逐步增加的社区水库。如果资源不与MRSA流行率成比例，隔离政策可能会“灾难性地”失败。"
Methicillin-resistant Staphylococcus aureus (MRSA) represents a serious threat to the health of hospitalized patients. Attempts to reduce the spread of MRSA have largely depended on hospital hygiene and patient isolation. These measures have met with mixed success: although some countries have almost eliminated MRSA or remained largely free of the organism, others have seen substantial increases despite rigorous control policies. We use a mathematical model to show how these increases can be explained by considering both hospital and community reservoirs of MRSA colonization. We show how the timing of the intervention, the level of resource provision, and chance combine to determine whether control measures succeed or fail. We find that even control measures able to repeatedly prevent sustained outbreaks in the short-term can result in long-term control failure resulting from gradual increases in the community reservoir. If resources do not scale with MRSA prevalence, isolation policies can fail "catastrophically."