title: Vancomycin-resistant enterococci colonization-infection model: parameter impacts and outbreak risks.
abstract: Vancomycin-resistant enterococci (VRE) infections have been linked to increased mortality and costs. A new model of a VRE-infested intensive care unit (ICU) is introduced. It incorporates critical features including the difference between colonization and infection, the role of special preventive care treatment cycles, fitness cost, and antibiotic use. Five patient stages are considered: susceptible, colonized with and without special preventive care, and infected with and without treatment. Parameter ranges are determined representing different ICUs and incorporated to numerically simulate the model. Basic reproductive number of the infection is derived and the impacts of the parameters are analysed. Strategies to minimize VRE infections and outbreak risk are explored with a focus on efficient and simultaneous control of critical parameters. In particular, threshold values of the level of special preventive care and ICU compliance rate are given to achieve desired goals under various constraints.
authors.affiliation: Department of Mathematics and Computer Science, Ursinus College, Collegeville, PA 19426, USA. myahdi@ursinus.edu
authors.forename: Mohammed
authors.initials: M
authors.lastname: Yahdi
authors.forename: Sara
authors.initials: S
authors.lastname: Abdelmageed
authors.forename: Jon
authors.initials: J
authors.lastname: Lowden
authors.forename: Lloyd
authors.initials: L
authors.lastname: Tannenbaum
mesh_terms: D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D050936:Basic Reproduction Number / Q000706:statistics & numerical data; D015169:Colony Count, Microbial; D003198:Computer Simulation; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D016983:Enterococcus / Q000187:drug effects* / Q000254:growth & development*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008954:Models, Biological; D012307:Risk Factors; D014640:Vancomycin / Q000494:pharmacology*
chemical_list: D014640:Vancomycin