Modeling of the transmission dynamics of carbapenem resistant Klebsiella pneumoniae in hospitals and design of control strategies

Abstract

Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged as a major threat to global public health. Epidemiological and infection controls associated with CRKP are very challenging owing to several potential elements involved in a complicated cycle of transmission. Here, we proposed a comprehensive mathematical model to investigate the transmission dynamics of CRKP, determine factors affecting the prevalence, and evaluate the impact of interventions on the transmission. The model includes the essential compartments, which are uncolonized, asymptomatic colonized, symptomatic colonized, and relapsed patients. Moreover, the symptomatic colonized and relapsed patients are further classified into subpopulations according to their number of treatment failures or relapses. We found that the admission of colonized patients and the use of antibiotics have a significant influence on the endemic transmission. The proposed treatment efficacy, which is defined as a combination of the treatment duration and the probability of successful treatment, could also describe the effects of antibiotic treatment on the transmission. A high efficacy of the antibiotic treatment could significantly reduce the likelihood of readmission of a patient in the health care unit. In addition, our findings demonstrate that the CRKP transmission with different epidemiological characteristics needs to be controlled with distinct interventions.