Optimal control of methicillin-resistant Staphylococcus aureus transmission in hospital settings

•Model DFE is locally-asymptotically stable whenever R0 is less than unity.•Model DFE is locally-asymptotically unstable if R0 is greater than unity.•Hand washing, decolonization and contamination rates have strong impacts the model.•Admission rates and isolation of colonized patients have strong im...

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Bibliographic Details
Published in:Applied mathematical modelling 2016-04, Vol.40 (7-8), p.4822-4843
Main Author: Agusto, F.B.
Format: Article
Language:English
Subjects:
Bacteria
Community-associated MRSA
Hospital-acquired MRSA
Hospitals
Mathematical models
MRSA
Optimal control theory
Patients
Reproduction
Sensitivity analysis
Staphylococcus aureus
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Summary:•Model DFE is locally-asymptotically stable whenever R0 is less than unity.•Model DFE is locally-asymptotically unstable if R0 is greater than unity.•Hand washing, decolonization and contamination rates have strong impacts the model.•Admission rates and isolation of colonized patients have strong impacts the model.•Decolonization and environmental contamination rates as controls can be reduce MRSA. Methicillin-resistant Staphylococcus aureus (MRSA) infections are caused by strains of Staphylococcus aureus bacteria with resistance to the standard antibiotics that are often used for the treatment of ordinary Staphylococcus aureus infections. In this study, a deterministic model is presented for the transmission dynamics of hospital- and community-acquired MRSA in a hospital setting. 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. The sensitivity analysis results show that the model outputs are affected by the hand washing compliance rate, decolonization rate of health-care workers, environmental contamination rate, hospital admission rates, and the isolation rate of colonized patients. Optimal control theory is then applied to investigate the goal of minimizing the colonization and infection of patients and health-care workers with MRSA using two time control variables (effects of the decolonization of health-care workers and environmental contamination rates) obtained from the sensitivity analysis.
ISSN:0307-904X
DOI:10.1016/j.apm.2015.12.006