Multiple transmission routes in nosocomial bacterial infections — A modeling study

In this paper, we propose a new mathematical model to investigate nosocomial infections caused by both antibiotic-sensitive and antibiotic-resistant bacteria. A focus of our modeling study is the presence of multiple transmission pathways, including the primary infection, co-infection, and re-infection from each type of bacteria, and their interplay with each other in the process of disease spread. We calibrate this model to clinical data and quantify the effects of each transmission route in the epidemic development and evolution. Our data fitting and numerical simulation results indicate that resistant bacteria play a more significant role than sensitive bacteria in shaping the hospital epidemics in our study, highlighting the importance of effective prevention and intervention strategies for antibiotic-resistant bacteria. We also find that the primary infection and re-infection have a larger impact than the co-infection on the short-term and long-term progression of the epidemics.