title: A data-driven mathematical model of multi-drug resistant Acinetobacter baumannii transmission in an intensive care unit.
abstract: Major challenges remain when attempting to quantify and evaluate the impacts of contaminated environments and heterogeneity in the cohorting of health care workers (HCWs) on hospital infections. Data on the detection rate of multidrug-resistant Acinetobacter baumannii (MRAB) in a Chinese intensive care unit (ICU) were obtained to accurately evaluate the level of environmental contamination and also to simplify existing models. Data-driven mathematical models, including mean-field and pair approximation models, were proposed to examine the comprehensive effect of integrated measures including cohorting, increasing nurse-patient ratios and improvement of environmental sanitation on MRAB infection. Our results indicate that for clean environments and with strict cohorting, increasing the nurse-patient ratio results in an initial increase and then a decline in MRAB colonization. In contrast, in contaminated environments, increasing the nurse-patient ratio may lead to either a consistent increase or an initial increase followed by a decline of MRAB colonization, depending on the level of environmental contamination and the cohorting rate. For developing more effective control strategies, the findings suggest that increasing the cohorting rate and nurse-patient ratio are effective interventions for relatively clean environments, while cleaning the environment more frequently and increasing hand washing rate are suitable measures in contaminated environments.
authors: Department of Applied Mathematics, Xi'an Jiaotong University, Xi'an 710049, China.
authors: Xia
authors: X
authors: Wang
authors: Center for Hospital Infection Control, Chinese PLA Institute for Disease Control and Prevention, 20# Dongda Street, 100071 Beijing, China.
authors: Yong
authors: Y
authors: Chen
authors: Center for Hospital Infection Control, Chinese PLA Institute for Disease Control and Prevention, 20# Dongda Street, 100071 Beijing, China.
authors: Wei
authors: W
authors: Zhao
authors: Center for Hospital Infection Control, Chinese PLA Institute for Disease Control and Prevention, 20# Dongda Street, 100071 Beijing, China.
authors: Yan
authors: Y
authors: Wang
authors: Department of Surgical Intensive Care Unit, Chinese PLA General Hospital, 100853 Beijing, China.
authors: Qing
authors: Q
authors: Song
authors: Department of Surgical Intensive Care Unit, Chinese PLA General Hospital, 100853 Beijing, China.
authors: Hui
authors: H
authors: Liu
authors: Center for Hospital Infection Control, Chinese PLA Institute for Disease Control and Prevention, 20# Dongda Street, 100071 Beijing, China.
authors: Jingya
authors: J
authors: Zhao
authors: Center for Hospital Infection Control, Chinese PLA Institute for Disease Control and Prevention, 20# Dongda Street, 100071 Beijing, China.
authors: Xuelin
authors: X
authors: Han
authors: Center for Hospital Infection Control, Chinese PLA Institute for Disease Control and Prevention, 20# Dongda Street, 100071 Beijing, China.
authors: Xiaohua
authors: X
authors: Hu
authors: Department of Medical Microbiology, University Medical Centre Groningen, Groningen, The Netherlands.
authors: Hajo
authors: H
authors: Grundmann
authors: Department of Applied Mathematics, Xi'an Jiaotong University, Xi'an 710049, China.
authors: Yanni
authors: Y
authors: Xiao
authors: Center for Hospital Infection Control, Chinese PLA Institute for Disease Control and Prevention, 20# Dongda Street, 100071 Beijing, China.
authors: Li
authors: L
authors: Han
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects / Q000472:pathogenicity*; D003428:Cross Infection; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D008962:Models, Theoretical