Modeling of Community- and Hospital-acquired Methicillin-resistant Staphylococcus Aureus Transmission in Hospital Settings

BIOMATH(2015)

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摘要
In this paper we developed both deterministicand stochastic models of community- and hospital-acquired methicillin-resistant staphylococcus aureus transmission (MRSA) to quantify their interactions in a hospital settings. The disease-free equilibrium of the model is locally-asymptotically stable whenever the associated reproduction number is less than unity. The disease persists in the community whenever the reproduction number is greater than unity. Although our stochastic model evolves on an unbounded state space, we show it is positive recurrent. The result obtained from the sensitivity analysis using the deterministic model indicates that the dominant parameters are the hand washing compliance rate, the health-care workers decolonization rate, environmental contamination rate, the admission rates into the hospital, isolation rate of patients with CA-MRSA and isolation rate of patients with HA-MRSA, the transmission probabilities of CA- and HA-MRSA per contact with health-care workers and transmission probability of health-care workers per contact with patients. Numerical simulations of the deterministic model obtained from using the dominate parameters as combination of control strategies such as low-, moderate and high-effectiveness control strategies show that disease prevalence among the hospital patients and the bacterial in the hospital environment can be controlled by moderate- and high-effectiveness control strategies. However, for health-care workers the disease prevalence can only be effectively controlled by the high-effectiveness control strategy.
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关键词
sensitivity analysis,continuous time markov chain,disease prevalence
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