Dynamics and control of multidrug-resistant bacterial infection in hospital with multiple delays

Abstract

A delayed model of hospital acquired infection of multidrug-resistant bacteria Acinatobactor baumannii is studied using three separate patient states, two healthcare worker states and environmental bacterial load. As this bacteria is characterized by longevity in hospital environment, the effect of delay in decontamination is investigated in detail. Another delay is considered in diagnostic procedure for treatment of multidrug-resistant bacteria. Increment in delay values initiate periodic dynamics of endemic state, which is demonstrated both analytically and numerically. The presence of Hopf bifurcation and chaotic attractor for other parameters indicate the rich dynamics of model system in fixed delayed environment. Optimal control technique is used to estimate effectiveness of various controls in reducing infection while minimizing the associated cost. The sensitivity analysis has identified parameters having significant influence on disease dynamics. It is observed that, antibiotic stewardship program has stronger impact on delayed antibiotic-resistant infection dynamics compared to hand hygiene compliance of healthcare workers.