A review of transmission models of methicillin-resistant Staphylococcus aureus in non-hospital residential facilities
Refereed conference paper presented and published in conference proceedings


Methicillin-resistant Staphylococcus aureus (MRSA) induces infections that are difficult to treat because of its ability to survive most antibiotics. The World Health Organization has recently listed MRSA as one of the priority pathogens posing threat to human health. Transmission and epidemiological characteristics of MRSA in long-term care facilities (LTCFs) may be different from those in hospitals, and may contribute extensively to community level transmission.

Numerous mathematical models have been employed to depict MRSA transmission in hospital settings, but the conclusions and public health implications drawn from these studies may not be applicable to non-hospital settings.

A systematic review of mathematical models for the MRSA transmission in non-hospital residential facilities is conducted to:
1. Provide an overview of epidemiological understanding of MRSA transmission
2. Identify future research direction in this area

Non-hospital residential facilities were defined as non-hospital settings where individuals resided for a substantial period of time. Such facilities included correctional facilities (CFs) and LTCFs. An initial search using the PUBMED database in the field “Title/Abstract” was conducted using search terms related to MRSA, models and non-hospital residential facilities. The search was further expanded by internet searches with Google search engine. Only articles depicting epidemiological transmission pathways of MRSA / community-associated MRSA within and between defined non-hospital residential settings were included. Population-level studies were excluded.

Ten articles were identified from the PUBMED database and by internet searches (Figure 1). Three studies focused on MRSA transmission dynamics within NHs, three focused on that associated with CFs, and four focused on that between facilities. Seven aspects of basic epidemiology of MRSA in non-hospital residential settings and model frameworks of included studies were summarized. Highlights of modelling frameworks were also summarized.

1. Role of Health-care workers (HCWs) and residents in transmission mechanisms within NHs
2. Intervention strategies to control MRSA transmission within NHs
3. Persistence of MRSA within NHs
4. Outbreak potential within CFs
5. Impact of CF-community MRSA dynamics
6. Impact of LTCF-hospital MRSA dynamics
7. Intervention strategies to control inter-facility MRSA transmission

Highlights of modelling frameworks
Different representations of disease progression were defined. Endogenous and exogenous transmission pathways were explicitly stated in intra-facility and inter-facility transmission models. Endogenous pathways mainly described pathways that resulted in residents’ infection in NHs or CFs, such as contaminated hands of HCWs. Exogenous pathways focused on the imported colonized residents. Common assumptions made include homogeneous contact mixing within the facility and fixed patient transfer rates.
著者Kin On Kwok, Jonathan M. Read, Arthur Tang, Steven Riley, Kai Man Kam
會議名稱Epidemics6 - International Conference on Infectious Disease Dynamics

上次更新時間 2018-17-05 於 11:37