title: Competition of hospital-acquired and community-acquired methicillin-resistant Staphylococcus aureus strains in hospitals.
abstract: Recently, we [E.M.C. D’Agata, G.F. Webb, M.A. Horn, R.C. Moellering Jr., and S. Ruan, Modellingthe 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 interventionsaimed 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.
authors: Department of Mathematics, Vanderbilt University, Nashville, TN 37240, USA. glenn.f.webb@vanderbilt.edu
authors: Glenn F
authors: GF
authors: Webb
authors: Mary Ann
authors: MA
authors: Horn
authors: Erika M C
authors: EM
authors: D'Agata
authors: Robert C
authors: RC
authors: Moellering
authors: Shigui
authors: S
authors: Ruan
mesh_terms: D050936:Basic Reproduction Number; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D003198:Computer Simulation; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000502:physiology*; D008954:Models, Biological