Optimal control of environmental cleaning and antibiotic prescription in an epidemiological model of methicillin-resistant Staphylococcus aureus infections in hospitals

Qimin Huang, Xi Huo, Shigui Ruan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

We consider a deterministic model of Methicillin-resistant Staphylococcus aureus infections in hospitals with seasonal oscillations of the antibiotic prescription rate. The model compartments consist of uncolonized patients with or without antibiotic exposure, colonized patients with or without antibiotic exposure, uncontaminated or contaminated healthcare workers, and free-living bacteria in the environment. We apply optimal control theory to this seven-compartment periodic system of ordinary differential equations to reduce the number of colonized patients and density of bacteria in the environment while minimizing the cost associated with environmental cleaning and antibiotic use in a particular time period. Characterizations of optimal control strategies are formulated and the ways hospitals should adjust these strategies for different scenarios are discussed. Numerical simulations strongly suggest that environmental cleaning is essential in the control of MRSA infections and antibiotic usage is suggested to be maintained at the least possible level. Screening, isolating, and shortening the extremely lengthened stays of colonized patients with antibiotic use history are all effective intervention strategies.

Original languageEnglish (US)
Pages (from-to)13-30
Number of pages18
JournalMathematical Biosciences
Volume311
DOIs
StatePublished - May 1 2019

Fingerprint

Epidemiological Model
cross infection
Methicillin
Cleaning
Antibiotics
Methicillin-Resistant Staphylococcus aureus
Cross Infection
cleaning
Prescriptions
Infection
Optimal Control
antibiotics
Anti-Bacterial Agents
Bacteria
Compartment Model
Optimal Control Theory
Time varying systems
bacteria
Periodic Systems
Deterministic Model

Keywords

  • Antibiotic prescription rate
  • Environmental cleaning
  • Epidemiological model
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Optimal control

ASJC Scopus subject areas

  • Statistics and Probability
  • Modeling and Simulation
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Agricultural and Biological Sciences(all)
  • Applied Mathematics

Cite this

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title = "Optimal control of environmental cleaning and antibiotic prescription in an epidemiological model of methicillin-resistant Staphylococcus aureus infections in hospitals",
abstract = "We consider a deterministic model of Methicillin-resistant Staphylococcus aureus infections in hospitals with seasonal oscillations of the antibiotic prescription rate. The model compartments consist of uncolonized patients with or without antibiotic exposure, colonized patients with or without antibiotic exposure, uncontaminated or contaminated healthcare workers, and free-living bacteria in the environment. We apply optimal control theory to this seven-compartment periodic system of ordinary differential equations to reduce the number of colonized patients and density of bacteria in the environment while minimizing the cost associated with environmental cleaning and antibiotic use in a particular time period. Characterizations of optimal control strategies are formulated and the ways hospitals should adjust these strategies for different scenarios are discussed. Numerical simulations strongly suggest that environmental cleaning is essential in the control of MRSA infections and antibiotic usage is suggested to be maintained at the least possible level. Screening, isolating, and shortening the extremely lengthened stays of colonized patients with antibiotic use history are all effective intervention strategies.",
keywords = "Antibiotic prescription rate, Environmental cleaning, Epidemiological model, Methicillin-resistant Staphylococcus aureus (MRSA), Optimal control",
author = "Qimin Huang and Xi Huo and Shigui Ruan",
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AU - Huang, Qimin

AU - Huo, Xi

AU - Ruan, Shigui

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N2 - We consider a deterministic model of Methicillin-resistant Staphylococcus aureus infections in hospitals with seasonal oscillations of the antibiotic prescription rate. The model compartments consist of uncolonized patients with or without antibiotic exposure, colonized patients with or without antibiotic exposure, uncontaminated or contaminated healthcare workers, and free-living bacteria in the environment. We apply optimal control theory to this seven-compartment periodic system of ordinary differential equations to reduce the number of colonized patients and density of bacteria in the environment while minimizing the cost associated with environmental cleaning and antibiotic use in a particular time period. Characterizations of optimal control strategies are formulated and the ways hospitals should adjust these strategies for different scenarios are discussed. Numerical simulations strongly suggest that environmental cleaning is essential in the control of MRSA infections and antibiotic usage is suggested to be maintained at the least possible level. Screening, isolating, and shortening the extremely lengthened stays of colonized patients with antibiotic use history are all effective intervention strategies.

AB - We consider a deterministic model of Methicillin-resistant Staphylococcus aureus infections in hospitals with seasonal oscillations of the antibiotic prescription rate. The model compartments consist of uncolonized patients with or without antibiotic exposure, colonized patients with or without antibiotic exposure, uncontaminated or contaminated healthcare workers, and free-living bacteria in the environment. We apply optimal control theory to this seven-compartment periodic system of ordinary differential equations to reduce the number of colonized patients and density of bacteria in the environment while minimizing the cost associated with environmental cleaning and antibiotic use in a particular time period. Characterizations of optimal control strategies are formulated and the ways hospitals should adjust these strategies for different scenarios are discussed. Numerical simulations strongly suggest that environmental cleaning is essential in the control of MRSA infections and antibiotic usage is suggested to be maintained at the least possible level. Screening, isolating, and shortening the extremely lengthened stays of colonized patients with antibiotic use history are all effective intervention strategies.

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KW - Environmental cleaning

KW - Epidemiological model

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KW - Optimal control

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