The drug-resistant bac?te?ria known as MRSA, once con?fined to hos?pi?tals but now wide?spread in com?mu?ni?ties, will likely con?tinue to exist in both set?tings as sep?a?rate strains, accord?ing to a new study.
The pre?dic?tion that both strains will coex?ist is reas?sur?ing because pre?vi?ous pro?jec?tions indi?cated that the more inva?sive and fast-growing com?mu?nity strains would over?take and elim?i?nate hos?pi?tal strains, pos?si?bly pos?ing a threat to pub?lic health.
Researchers at Prince?ton Uni?ver?sity used math?e?mat?i?cal mod?els to explore what will hap?pen to com?mu?nity and hos?pi?tal MRSA strains, which dif?fer genet?i?cally.? Orig?i?nally MRSA, which is short for methicillin-resistant Staphy?lo?coc?cus aureus, was con?fined to hos?pi?tals. How?ever, community-associated strains emerged in the past decade and can spread widely from per?son to per?son in schools, ath?letic facil?i?ties and homes.
Both com?mu?nity and hos?pi?tal strains cause dis?eases rang?ing from skin and soft-tissue infec?tions to pneu?mo?nia and sep?ticemia. Hos?pi?tal MRSA is resis?tant to numer?ous antibi?otics and is very dif?fi?cult to treat, while com?mu?nity MRSA is resis?tant to fewer antibiotics.
The new study found that these dif?fer?ences in antibi?otic resis?tance, com?bined with more aggres?sive antibi?otic usage pat?terns in hos?pi?tals ver?sus the com?mu?nity set?ting, over time will per?mit hos?pi?tal strains to sur?vive despite the com?pe?ti?tion from com?mu?nity strains. Hospital-based antibi?otic usage is likely to suc?cess?fully treat patients infected with com?mu?nity strains, pre?vent?ing the new?comer strains from spread?ing to new patients and gain?ing the foothold they need to out-compete the hos?pi?tal strains.
The researchers made their pre?dic?tions by using math?e?mat?i?cal mod?els of MRSA trans?mis?sion that take into account data on drug-usage, resis?tance pro?files, person-to-person con?tact, and patient age.
Pub?lished Feb?ru?ary 28 in the jour?nal PLOS Pathogens, the study was con?ducted by post?doc?toral researcher Roger Kouyos, now a scholar at the Uni?ver?sity of Zurich, and Eili Klein, a grad?u?ate stu?dent who is now an assis?tant pro?fes?sor in the Johns Hop?kins School of Med?i?cine. They con?ducted the work under the advise?ment of Bryan Gren?fell, Princeton?s Kathryn Briger and Sarah Fen?ton Pro?fes?sor of Ecol?ogy and Evo?lu?tion?ary Biol?ogy and Pub?lic Affairs at Princeton?s Woodrow Wil?son School of Inter?na?tional and Pub?lic Affairs.
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Kouyos R., Klein E. & Gren?fell B. (2013). Hospital-Community Inter?ac?tions Fos?ter Coex?is?tence between Methicillin-Resistant Strains of Staphy?lo?coc?cus aureus. PLoS Pathogens, 9 (2) e1003134. PMID: 23468619
RK was sup?ported by the Swiss National Sci?ence Foun?da?tion (Grants PA00P3_131498 and PZ00P3_142411). EK was sup?ported by Prince?ton Uni?ver?sity (Harold W. Dodds Fel?low?ship), as well as the Mod?els of Infec?tious Dis?ease Agent Study (MIDAS), under Award Num?ber U01GM070708 from the National Insti?tute of Gen?eral Med?ical Sci?ences. BG was sup?ported by the Bill and Melinda Gates Foun?da?tion; the Research and Pol?icy for Infec?tious Dis?ease Dynam?ics (RAPIDD) pro?gram of the Sci?ence and Tech?nol?ogy Direc?torate, Depart?ment of Home?land Secu?rity; and the Fog?a?rty Inter?na?tional Cen?ter, National Insti?tutes of Health.
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By Cather?ine Zan?donella, Office of the Dean for Research
Princeton University
Provided by ArmMed Media
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