MRSA Transmission Reduction Using Agent-Based Modeling and Simulation

被引:29
作者
Barnes, Sean [1 ]
Golden, Bruce [2 ]
Wasil, Edward [3 ]
机构
[1] Univ Maryland, Dept Math, College Pk, MD 20742 USA
[2] Univ Maryland, Robert H Smith Sch Business, College Pk, MD 20742 USA
[3] American Univ, Kogod Sch Business, Washington, DC 20016 USA
关键词
simulation; health care; epidemiology; probability; stochastic model applications; RESISTANT STAPHYLOCOCCUS-AUREUS;
D O I
10.1287/ijoc.1100.0386
中图分类号
TP39 [计算机的应用];
学科分类号
081203 ; 0835 ;
摘要
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant ongoing problem in health care, posing a substantial threat to hospitals and communities as well. Its spread among patients causes many downstream effects, such as a longer length of stay for patients, higher costs for hospitals and insurance companies, and fatalities. An agent-based simulation model is developed to investigate the dynamics of MRSA transmission within a hospital. The simulation model is used to examine the effectiveness of various infection control procedures and explore more specific questions relevant to hospital administrators and policy makers. Simulation experiments are performed to examine the effects of hand-hygiene compliance and efficacy, patient screening, decolonization, patient isolation, and health-care worker-to-patient ratios on the incidence of MRSA-transmission and other relevant metrics. Experiments are conducted to investigate the dynamic between the number of colonizations directly attributable to nurses and physicians, including rogue health-care workers who practice poor hygiene. We begin to explore the most likely threats to trigger an outbreak in hospitals that practice high hand-hygiene compliance and additional preventive measures.
引用
收藏
页码:635 / 646
页数:12
相关论文
共 13 条
[1]  
[Anonymous], WALL STREET J 0814
[2]   Studies of antibiotic resistance within the patient, hospitals and the community using simple mathematical models [J].
Austin, DJ ;
Anderson, RM .
PHILOSOPHICAL TRANSACTIONS OF THE ROYAL SOCIETY B-BIOLOGICAL SCIENCES, 1999, 354 (1384) :721-738
[3]   Increasing the frequency of hand washing by healthcare workers does not lead to commensurate reductions in staphylococcal infection in a hospital ward [J].
Beggs, Clive B. ;
Shepherd, Simon J. ;
Kerr, Kevin G. .
BMC INFECTIOUS DISEASES, 2008, 8 (1)
[4]   Controlling methicillin-resistant Staphylococcus aureus:: Quantifying the effects of interventions and rapid diagnostic testing [J].
Bootsma, MCJ ;
Diekmann, O ;
Bonten, MJM .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2006, 103 (14) :5620-5625
[5]  
*COMM RED INF DEAT, RID
[6]   Preliminary analysis of the transmission dynamics of nosocomial infections: stochastic and management effects [J].
Cooper, BS ;
Medley, GF ;
Scott, GM .
JOURNAL OF HOSPITAL INFECTION, 1999, 43 (02) :131-147
[7]   The use and interpretation of quasi-experimental studies in medical informatics [J].
Harris, AD ;
McGregor, JC ;
Perencevich, EN ;
Furuno, JP ;
Zhu, JK ;
Peterson, DE ;
Finkelstein, J .
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION, 2006, 13 (01) :16-23
[8]   Contribution to the mathematical theory of epidemics [J].
Kermack, WO ;
McKendrick, AG .
PROCEEDINGS OF THE ROYAL SOCIETY OF LONDON SERIES A-CONTAINING PAPERS OF A MATHEMATICAL AND PHYSICAL CHARACTER, 1927, 115 (772) :700-721
[9]  
Macal CM, 2007, PROCEEDINGS OF THE 2007 WINTER SIMULATION CONFERENCE, VOLS 1-5, P83
[10]   A stochastic mathematical model of methicillin resistant Staphylococcus aureus transmission in an intensive care unit:: Predicting the impact of interventions [J].
McBryde, E. S. ;
Pettitt, A. N. ;
McElwain, D. L. S. .
JOURNAL OF THEORETICAL BIOLOGY, 2007, 245 (03) :470-481