Hospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.

Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of morbidity and mortality in both hospitals and the community. Traditionally, MRSA was mainly hospital-associated (HA-MRSA), but in the past decade community-associated strains (CA-MRSA) have spread widely. CA-MRSA strains see...

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Autores principales:	Roger Kouyos, Eili Klein, Bryan Grenfell
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Immunologic diseases. Allergy RC581-607 Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/956f96015610402c9f2740486d65873f
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spelling	oai:doaj.org-article:956f96015610402c9f2740486d65873f2021-11-18T06:06:00ZHospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.1553-73661553-737410.1371/journal.ppat.1003134https://doaj.org/article/956f96015610402c9f2740486d65873f2013-02-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23468619/pdf/?tool=EBIhttps://doaj.org/toc/1553-7366https://doaj.org/toc/1553-7374Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of morbidity and mortality in both hospitals and the community. Traditionally, MRSA was mainly hospital-associated (HA-MRSA), but in the past decade community-associated strains (CA-MRSA) have spread widely. CA-MRSA strains seem to have significantly lower biological costs of resistance, and hence it has been speculated that they may replace HA-MRSA strains in the hospital. Such a replacement could potentially have major consequences for public health, as there are differences in the resistance spectra of the two strains as well as possible differences in their clinical effects. Here we assess the impact of competition between HA- and CA-MRSA using epidemiological models which integrate realistic data on drug-usage frequencies, resistance profiles, contact, and age structures. By explicitly accounting for the differing antibiotic usage frequencies in the hospital and the community, we find that coexistence between the strains is a possible outcome, as selection favors CA-MRSA in the community, because of its lower cost of resistance, while it favors HA-MRSA in the hospital, because of its broader resistance spectrum. Incorporating realistic degrees of age- and treatment-structure into the model significantly increases the parameter ranges over which coexistence is possible. Thus, our results indicate that the large heterogeneities existing in human populations make coexistence between hospital- and community-associated strains of MRSA a likely outcome.Roger KouyosEili KleinBryan GrenfellPublic Library of Science (PLoS)articleImmunologic diseases. AllergyRC581-607Biology (General)QH301-705.5ENPLoS Pathogens, Vol 9, Iss 2, p e1003134 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607 Biology (General) QH301-705.5
spellingShingle	Immunologic diseases. Allergy RC581-607 Biology (General) QH301-705.5 Roger Kouyos Eili Klein Bryan Grenfell Hospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.
description	Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of morbidity and mortality in both hospitals and the community. Traditionally, MRSA was mainly hospital-associated (HA-MRSA), but in the past decade community-associated strains (CA-MRSA) have spread widely. CA-MRSA strains seem to have significantly lower biological costs of resistance, and hence it has been speculated that they may replace HA-MRSA strains in the hospital. Such a replacement could potentially have major consequences for public health, as there are differences in the resistance spectra of the two strains as well as possible differences in their clinical effects. Here we assess the impact of competition between HA- and CA-MRSA using epidemiological models which integrate realistic data on drug-usage frequencies, resistance profiles, contact, and age structures. By explicitly accounting for the differing antibiotic usage frequencies in the hospital and the community, we find that coexistence between the strains is a possible outcome, as selection favors CA-MRSA in the community, because of its lower cost of resistance, while it favors HA-MRSA in the hospital, because of its broader resistance spectrum. Incorporating realistic degrees of age- and treatment-structure into the model significantly increases the parameter ranges over which coexistence is possible. Thus, our results indicate that the large heterogeneities existing in human populations make coexistence between hospital- and community-associated strains of MRSA a likely outcome.
format	article
author	Roger Kouyos Eili Klein Bryan Grenfell
author_facet	Roger Kouyos Eili Klein Bryan Grenfell
author_sort	Roger Kouyos
title	Hospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.
title_short	Hospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.
title_full	Hospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.
title_fullStr	Hospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.
title_full_unstemmed	Hospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.
title_sort	hospital-community interactions foster coexistence between methicillin-resistant strains of staphylococcus aureus.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/956f96015610402c9f2740486d65873f
work_keys_str_mv	AT rogerkouyos hospitalcommunityinteractionsfostercoexistencebetweenmethicillinresistantstrainsofstaphylococcusaureus AT eiliklein hospitalcommunityinteractionsfostercoexistencebetweenmethicillinresistantstrainsofstaphylococcusaureus AT bryangrenfell hospitalcommunityinteractionsfostercoexistencebetweenmethicillinresistantstrainsofstaphylococcusaureus
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Hospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.

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