Systematic review of isolation policies in the hospital management of methicillin-resistant Staphylococcus aureus: a review of the literature with epidemiological and economic modelling

Abstract

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Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

“…There have been a number of previous models looking specifically at nosocomial infection transmission dynamics [10][11][12][13][14][15][16][17][18][19]. This work builds on those studies, particularly those by Cooper et al [4,18,19] which use stochastic models to explore the spread of nosocomial pathogens. The novel aspect of this work, however, is that we model transmission between a hospital and community and within this setting include both control (by isolation) as well as active surveillance, in a single framework.…”

“…The framework is based closely on Cooper et al [4,19]. Briefly, we model a closed population consisting of both a fixed-size hospital and the community it serves.…”

“…Discharged patients at first enter the group with a high readmission rate (C 1 ) from where, if they are not readmitted, they move at a set rate to the second community group (C 2 ) with a lower readmission rate [4]. The number of susceptible and infected individuals in C 1 and C 2 are denoted S C 1 , I C 1 , S C 2 and I C 2 respectively.…”

“…However, studies on control measures are limited [3] and evidence for their effectiveness sparse and often contradictory [4]. Current guidelines are based on medical and scientific rationale and suggestive evidence rather than study results [4].…”

“…However, studies on control measures are limited [3] and evidence for their effectiveness sparse and often contradictory [4]. Current guidelines are based on medical and scientific rationale and suggestive evidence rather than study results [4]. However, with infection rates relentlessly increasing, old guidelines have become unfeasible and impractical to perform and now flexible, targeted approaches tend to be favoured [5].…”