Synergistic Effect of Combination Interventions for Methicillin-Resistant <i>Staphylococcus aureus</i> Transmission Control in Nursing Homes: A Computation Modelling Evaluation with Heterogeneous Contact Mixing
The endemic threat of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) in nursing homes poses a serious and escalating challenge to public health administration in infection control. Nursing homes are considered as major reservoirs for MRSA colonization, with considerable high l...
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| Format: | Article |
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MDPI AG
2021-02-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/3/227 |
| _version_ | 1797395477907374080 |
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| author | Arthur Tang Kin On Kwok Vivian Wan In Wei Hong Chen Samuel Yeung Shan Wong Wilson Wai Sun Tam |
| author_facet | Arthur Tang Kin On Kwok Vivian Wan In Wei Hong Chen Samuel Yeung Shan Wong Wilson Wai Sun Tam |
| author_sort | Arthur Tang |
| collection | DOAJ |
| description | The endemic threat of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) in nursing homes poses a serious and escalating challenge to public health administration in infection control. Nursing homes are considered as major reservoirs for MRSA colonization, with considerable high levels of colonization prevalence. We employed a computation model to evaluate effects of three intervention scenarios on MRSA colonization prevalence rate in nursing homes. Simulations were conducted using a deterministic compartmental model featuring heterogeneous contact matrix between residents and health-care workers (HCWs). Contact parameters were derived from a nursing home survey. Three intervention scenarios were simulated: (1) hand-hygiene compliance by HCWs, (2) screening-and-isolation upon admission, and (3) implementing both interventions at the same time. For every 10% reduction in average contamination duration in HCWs, the estimated average reduction in prevalence rate was 1.29 percentage point compared with the prevalence rate before the intervention was implemented. Screening-and-isolation intervention resulted in an average reduction of 19.04 percentage point in prevalence rate (S.D. = 1.58; 95% CI = 18.90–19.18). In intervention scenario 3, synergistic effects were observed when implementing hand-hygiene compliance by HCWs and screening-and-isolation together. Our results provide evidence showing that implementing multiple interventions together has a synergistic effect on colonization prevalence reduction. |
| first_indexed | 2024-03-09T00:35:06Z |
| format | Article |
| id | doaj.art-fd55c4ad953644d084c3ca669198afea |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T00:35:06Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-fd55c4ad953644d084c3ca669198afea2023-12-11T18:15:54ZengMDPI AGAntibiotics2079-63822021-02-0110322710.3390/antibiotics10030227Synergistic Effect of Combination Interventions for Methicillin-Resistant <i>Staphylococcus aureus</i> Transmission Control in Nursing Homes: A Computation Modelling Evaluation with Heterogeneous Contact MixingArthur Tang0Kin On Kwok1Vivian Wan In Wei2Hong Chen3Samuel Yeung Shan Wong4Wilson Wai Sun Tam5Department of Software, Sungkyunkwan University, Suwon 16419, KoreaJC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, ChinaJC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, ChinaCentre for Health Protection, Department of Health, Hong Kong 999077, ChinaJC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, ChinaAlice Lee Centre for Nursing Studies, National University of Singapore, Singapore 117597, SingaporeThe endemic threat of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) in nursing homes poses a serious and escalating challenge to public health administration in infection control. Nursing homes are considered as major reservoirs for MRSA colonization, with considerable high levels of colonization prevalence. We employed a computation model to evaluate effects of three intervention scenarios on MRSA colonization prevalence rate in nursing homes. Simulations were conducted using a deterministic compartmental model featuring heterogeneous contact matrix between residents and health-care workers (HCWs). Contact parameters were derived from a nursing home survey. Three intervention scenarios were simulated: (1) hand-hygiene compliance by HCWs, (2) screening-and-isolation upon admission, and (3) implementing both interventions at the same time. For every 10% reduction in average contamination duration in HCWs, the estimated average reduction in prevalence rate was 1.29 percentage point compared with the prevalence rate before the intervention was implemented. Screening-and-isolation intervention resulted in an average reduction of 19.04 percentage point in prevalence rate (S.D. = 1.58; 95% CI = 18.90–19.18). In intervention scenario 3, synergistic effects were observed when implementing hand-hygiene compliance by HCWs and screening-and-isolation together. Our results provide evidence showing that implementing multiple interventions together has a synergistic effect on colonization prevalence reduction.https://www.mdpi.com/2079-6382/10/3/227antimicrobial resistancemethicillin-resistant <i>Staphylococcus aureus</i> transmissionsimulation and modellingnursing homeinterventionssynergistic effect |
| spellingShingle | Arthur Tang Kin On Kwok Vivian Wan In Wei Hong Chen Samuel Yeung Shan Wong Wilson Wai Sun Tam Synergistic Effect of Combination Interventions for Methicillin-Resistant <i>Staphylococcus aureus</i> Transmission Control in Nursing Homes: A Computation Modelling Evaluation with Heterogeneous Contact Mixing Antibiotics antimicrobial resistance methicillin-resistant <i>Staphylococcus aureus</i> transmission simulation and modelling nursing home interventions synergistic effect |
| title | Synergistic Effect of Combination Interventions for Methicillin-Resistant <i>Staphylococcus aureus</i> Transmission Control in Nursing Homes: A Computation Modelling Evaluation with Heterogeneous Contact Mixing |
| title_full | Synergistic Effect of Combination Interventions for Methicillin-Resistant <i>Staphylococcus aureus</i> Transmission Control in Nursing Homes: A Computation Modelling Evaluation with Heterogeneous Contact Mixing |
| title_fullStr | Synergistic Effect of Combination Interventions for Methicillin-Resistant <i>Staphylococcus aureus</i> Transmission Control in Nursing Homes: A Computation Modelling Evaluation with Heterogeneous Contact Mixing |
| title_full_unstemmed | Synergistic Effect of Combination Interventions for Methicillin-Resistant <i>Staphylococcus aureus</i> Transmission Control in Nursing Homes: A Computation Modelling Evaluation with Heterogeneous Contact Mixing |
| title_short | Synergistic Effect of Combination Interventions for Methicillin-Resistant <i>Staphylococcus aureus</i> Transmission Control in Nursing Homes: A Computation Modelling Evaluation with Heterogeneous Contact Mixing |
| title_sort | synergistic effect of combination interventions for methicillin resistant i staphylococcus aureus i transmission control in nursing homes a computation modelling evaluation with heterogeneous contact mixing |
| topic | antimicrobial resistance methicillin-resistant <i>Staphylococcus aureus</i> transmission simulation and modelling nursing home interventions synergistic effect |
| url | https://www.mdpi.com/2079-6382/10/3/227 |
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