Methicillin-resistant Staphylococcus aureus in hospitals and the community: Stealth dynamics and control catastrophes.


Cooper, BS; Medley, GF; Stone, SP; Kibbler, CC; Cookson, BD; Roberts, JA; Duckworth, G; Lai, R; Ebrahim, S; (2004) Methicillin-resistant Staphylococcus aureus in hospitals and the community: Stealth dynamics and control catastrophes. Proceedings of the National Academy of Sciences of the United States of America, 101 (27). pp. 10223-8. ISSN 0027-8424 DOI: https://doi.org/10.1073/pnas.0401324101

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Abstract

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."

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 15220470
Web of Science ID: 222534200051
URI: http://researchonline.lshtm.ac.uk/id/eprint/14621

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