Abstract
ABSTRACTOptimal control methods are applied to a deterministic mathematical model to characterize the factors contributing to the replacement of hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), and quantify the effectiveness of three interventions aimed at limiting the spread of CA-MRSA in healthcare settings. Characterizations of the optimal control strategies are established, and numerical simulations are provided to illustrate the results.
Highlights
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacteria that is resistant to many antibiotics
The model in [4, 5] was formulated for patients and Health Care Workers (HCWs) divided into the following five compartments: S(t) = number of susceptible patients at time t, CC(t) = number of patients colonized with the community-acquired strain of MRSA (CA-MRSA) strain at time t, CH(t) = number of patients colonized with the Hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) strain at time t, IC(t) = number of patients infected with the CA-MRSA strain at time t, IH(t) = number of patients infected with the HA-MRSA strain at time t
Optimal 3-control strategies dramatically reduce the severity of the patients colonized with the CA-MRSA, patients infected with the CAMRSA, patients colonized with the HA-MRSA, and patients infected with the HA-MRSA, respectively, see Figure 3
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacteria that is resistant to many antibiotics. Hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) has long been a serious infection problem in hospitals and other healthcare settings. The analysis in [4, 5] strongly implied that CA-MRSA may eventually become dominant in hospital settings Intervention measures, such as improved hygiene, screening and decolonization of CA-MRSA carriers, and isolation of CA-MRSA infected patients, offer possibilities for epidemic control. Due to the competition between HA-MRSA and CA-MRSA strains in hospitals, the question of what are the most effective strategies for dealing with patients colonized or infected with the new CA-MRSA strain remains unanswered. Our objective here is to focus on optimal cost-effective strategies for combinations of decolonization of colonized CA-MRSA patients, and screening of colonized and infected CA-MRSA patients.
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