Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

• Published in: Epidemiology and infection Vol. 135; no. 2; pp. 328 - 342
• Main Authors: ROBOTHAM, J. V., JENKINS, D. R., MEDLEY, G. F.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01-02-2007
• Subjects: Antimicrobial agents; Bacteriology; Biological and medical sciences; Communities; Cross Infection - epidemiology; Cross Infection - prevention & control; Disease control; Disease transmission; Epidemics; Epidemiology; Fundamental and applied biological sciences. Psychology; Hospital admissions; Hospitals; Humans; Infection control; Infection Control - methods; Infections; Mass Screening - methods; Mathematics; Methicillin Resistance; Methicillin resistant staphylococcus aureus; Microbiology; Miscellaneous; Nosocomial infections; Pathogens; Patient surveillance; Patients; Population Surveillance - methods; Staphylococcal Infections - epidemiology; Staphylococcal Infections - prevention & control; Staphylococcus aureus; Staphylococcus aureus - isolation & purification; Staphylococcus infections; Stochastic models; Surveillance; United Kingdom > UK; Human; Microbiology; Bacteria; Micrococcales; Micrococcaceae; Epidemiology; Staphylococcus aureus
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S095026880600687X

With reports of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) continuing to increase and therapeutic options decrease, infection control methods are of increasing importance. Here we investigate the relationship between surveillance and infection control. Surveillance plays two roles with respect to control: it allows detection of infected/colonized individuals necessary for their removal from the general population, and it allows quantification of control success. We develop a stochastic model of MRSA transmission dynamics exploring the effects of two screening strategies in an epidemic setting: random and on admission. We consider both hospital and community populations and include control and surveillance in a single framework. Random screening was more efficient at hospital surveillance and allowed nosocomial control, which also prevented epidemic behaviour in the community. Therefore, random screening was the more effective control strategy for both the hospital and community populations in this setting. Surveillance strategies have significant impact on both ascertainment of infection prevalence and its control.