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Proc Natl Acad Sci U S A. 2004 Jul 6;101(27):10223-8. Epub 2004 Jun 25.

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

Author information

  • 1Department of Medical Microbiology, Royal Free and University College Medical School, University of London, WC1E 7HU, United Kingdom. ben.cooper@hpa.org.uk

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."

PMID:
15220470
[PubMed - indexed for MEDLINE]
PMCID:
PMC454191
Free PMC Article

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