A Dutch Approach to Methicillin-Resistant Staphylococcus aureus

Verhoef, J.; Beaujean, Desirée; Blok, Hetty E. M.; Baars, Arnold; Meyler, A; Werken, Chr. van der; Weersink, A. J. L.

doi:10.1007/s100960050324

Cited by 154 publications

(120 citation statements)

References 29 publications

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“…In The Netherlands, the frequency of MRSA infections is Ͻ0.5% after an intensive ''search-and-destroy'' campaign, compared with 50% in some areas (14). In Siouxland, an epidemic of VRE was reversed (15).…”

Section: Discussionmentioning

confidence: 99%

“…Although our assumption of time-invariant HIC expenditures is admittedly restrictive, it is largely true that hospitals do not make dynamically optimal resource allocations and are more likely to be responsive to problems with ARB as they arise. It is also possible that early investments in HIC can have long-term benefits by selecting for ARB that have lower transmissibility; an additional benefit of the Dutch campaign was to reduce the prevalence of those strains of S. aureus with the highest intrinsic transmission rates, making future HIC efforts easier (14). In our models, we ignored selection for lower transmissibility.…”

Section: Discussionmentioning

confidence: 99%

“…Multidrug resistance has been rare or absent in small and isolated communities. In a few notable success stories, large coordinated efforts have managed to reverse epidemics or keep the frequency of resistance low (14)(15)(16). Although there are epidemiological reasons why resistance may have arisen more rapidly in urban settings with closer contact between people, the role of HIC within hospitals is important to examine in greater detail.…”

mentioning

confidence: 99%

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Strategic interactions in multi-institutional epidemics of antibiotic resistance

Smith

Levin

Laxminarayan

2005

Proc. Natl. Acad. Sci. U.S.A.

109

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The increasing frequency of antibiotic resistance in hospital-acquired infections is a major public health concern that has both biological and economic causes. Here we develop conceptual mathematical models that couple the economic incentives and population biology of hospital infection control (HIC). We show that the optimal investment by a hospital for HIC changes with the proportion of patients already colonized with antibiotic-resistant bacteria (ARB) at the time of admission. As that proportion increases, the optimal behavior of a hospital is to increase spending to control ARB with low transmissibility and decrease spending on those with high transmissibility. In some cases, the global optimum investment in HIC can shift discontinuously from one that contains transmission to a do-nothing policy once the proportion already colonized at the time of admission becomes too great. We also show that investments in HIC are determined by a strategic game when several hospitals share patients. Hospitals acting selfishly and rationally will free-ride on the investments of other hospitals, and the level of free-riding should increase with the number of other hospitals in the area. Thus, in areas with many hospitals, the rational strategy for each hospital is to spend less than in areas with few hospitals. Thus, we predict that transmission rates and the prevalence of ARB should be higher in urban hospitals, for instance, compared with rural hospitals. We conclude that regional coordination and planning for HIC is an essential element of public health planning for hospital-acquired infections.game theory ͉ nosocomial infections ͉ infection control ͉ optimal control ͉ transmission dynamics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Strategic interactions in multi-institutional epidemics of antibiotic resistance

Smith

Levin

Laxminarayan

2005

Proc. Natl. Acad. Sci. U.S.A.

109

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“…13 Various MRSA control strategies have been proposed, ranging from contact precautions and active surveillance to topical treatment and more aggressive policies, such as the Dutch MRSA program. 14,15 A recent prospective study performed in two English ICUs, though, demonstrated no reduction of MRSA cross-infection with isolation/cohorting of MRSA-positive patients. 16 In China, a study investigating the prevalence of MRSA and the susceptibility of S. aureus to 26 antimicrobial agents was carried out in 2005.…”

Section: Discussionmentioning

confidence: 98%

In vitro activity of minocycline combined with fosfomycin against clinical isolates of methicillin-resistant Staphylococcus aureus

et al. 2011

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This study aimed to evaluate the in vitro activity of minocycline combined with fosfomycin against isolates of methicillinresistant Staphylococcus aureus (MRSA). A total of 87 clinical isolates of MRSA collected from three Chinese hospitals were included in the study. The checkerboard method with determination of the fractional IC index (FICI) was used to determine whether antibiotic combinations act synergistically against these isolates. The susceptibility results for minocycline and fosfomycin were interpreted according to the most relevant criteria. The results demonstrated the following interactions: 76 isolates (87.4%) showed synergistic interactions (FICIp0.5) and 11 isolates (12.6%) showed indifferent interactions (0.5oFICIo4). No antagonistic interactions (FICIX4) were observed. The combination of minocycline and fosfomycin can be synergistic against MRSA. Further studies are required to determine the potential clinical role of this combination regimen as a therapeutic alternative for certain types of MRSA infections.

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“…The MRSA prevention methods in non-endemic countries, such as Finland, include careful hand desinfection after each patient contact, wearing gloves and a gown when caring for MRSA patients, treatment of colonized patients, and isolation of MRSA patients and suspected MRSA positive patients until three negative MRSA cultures have been obtained. (289,294). In Finland, a patient is suspected to be a MRSA carrier if the patient has previously been MRSA positive, has shared a room with a MRSA positive patient, has been hospitalized outside the Nordic countries within the past six months, or has been transferred from a hospital with an ongoing MRSA epidemic (294).…”

Section: Mrsa In Health Care Facilitiesmentioning

confidence: 99%

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Finland

Salmenlinna¹,

Lyytikäinen

Kotilainen

et al. 2000

European Journal of Clinical Microbiology & Infectious Dise

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A Dutch Approach to Methicillin-Resistant Staphylococcus aureus

Cited by 154 publications

References 29 publications

Strategic interactions in multi-institutional epidemics of antibiotic resistance

Strategic interactions in multi-institutional epidemics of antibiotic resistance

In vitro activity of minocycline combined with fosfomycin against clinical isolates of methicillin-resistant Staphylococcus aureus

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Finland

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