Lipsitch, MarcBergstrom, Carl T.2004-11-022007-06-132004-11-022007-06-132002Lipsitch, M. and C. T. Bergstrom. Chapter 19 in R. A. Weinstein and M. Bonten, eds., Infection Control in the ICU environment. Kluwer. 2002.0792374150http://hdl.handle.net/1773/1998Mathematical 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.78198 bytesapplication/pdfenBook chapter