Modeling of antibiotic resistance in the ICU - US Slant

Abstract

Mathematical models are valuable tools with which to predict and explain the epidemiology of nosocomial infection. As such, modeling will play a crucial role in the effort to control the growing threat posed in hospitals by antibiotic-resistant bacteria. In this chapter, we illustrate the utility of the model-based approach, using a simple mathematical model of colonization and infection by antibiotic-sensitive and resistant bacteria in a hospital setting. The model explains a number of otherwise counterintuitive observations regarding the spread of nosocomial resistance: (1) non-specific infection control measures such as hand-washing will disproportionately reduce the prevalence of resistant bacteria within the hospital; (2) resistance-control interventions should generate reductions in resistance much more rapidly in hospitals than in communities as a whole; (3) treatment with one antibiotic may be an individual risk factor for acquisition of resistance to another antibiotic, even in the absence of genetically linked resistance mechanisms.