ArticlePLoS pathogens2013
Hospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.
Article in PLoS pathogens, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Population-level mathematical modeling of antimicrobial resistance: a systematic review.BMC medicine · 2019Pooled it
- Impact of mupirocin resistance on the transmission and control of healthcare-associated MRSA.The Journal of antimicrobial chemotherapy · 2015Pooled it
- Fast hospital discharge rates blur within-hospital 'transmission footprint' in bacterial genomes, as showcased with Staphylococcus aureus.PLoS computational biology · 2026Article
- Quantifying the effects of antibiotic resistance and within-host competition on strain fitness in Streptococcus pneumoniae.PLoS biology · 2025Article
- A stochastic analysis of the interplay between antibiotic dose, mode of action, and bacterial competition in the evolution of antibiotic resistance.PLoS computational biology · 2023Article
- Methicillin-ResistantPathogens (Basel, Switzerland) · 2022Article
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- A dose response model for Staphylococcus aureus.Scientific reports · 2021Article
- Feline Otitis Externa Caused by Methicillin-ResistantAntibiotics (Basel, Switzerland) · 2021Article
- Population structure across scales facilitates coexistence and spatial heterogeneity of antibiotic-resistant infections.PLoS computational biology · 2020Article
- On the evolutionary ecology of multidrug resistance in bacteria.PLoS pathogens · 2019Article
- Host contact dynamics shapes richness and dominance of pathogen strains.PLoS computational biology · 2019Article
- Evolutionary epidemiology models to predict the dynamics of antibiotic resistance.Evolutionary applications · 2019Article
- CA-MRSA and HA-MRSA coexist in community and hospital settings in Uganda.Antimicrobial resistance and infection control · 2019Article
- Article
- Application of dynamic modelling techniques to the problem of antibacterial use and resistance: a scoping review.Epidemiology and infection · 2018Article
- The evolution of antibiotic resistance in a structured host population.Journal of the Royal Society, Interface · 2018Article
- Potential impact of introducing the pneumococcal conjugate vaccine into national immunisation programmes: an economic-epidemiological analysis using data from India.BMJ global health · 2018Article
- Host population structure and treatment frequency maintain balancing selection on drug resistance.Journal of the Royal Society, Interface · 2017Article
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3 authors.
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Abstract
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.
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