Inference and control of the nosocomial transmission of methicillin-resistant Staphylococcus aureus

Pei, Sen; Morone, Flaviano; Liljeros, Fredrik; Makse, Hernán; Shaman, Jeffrey L

Antimicrobial resistance is a global concern in healthcare systems due to its substantial morbidity and mortality burden and the lack of effective treatment options (CDC, 2013a; Magill et al., 2014; WHO, 2018) . Among antibiotic-resistant agents, Methicillin-resistant Staphylococcus aureus (MRSA) emerges as one of the most widespread and virulent pathogens Klevens et al., 2007; Klein et al., 2007; Jarvis et al., 2012) and has been highlighted as a leading cause of healthcare-associated infections (HAIs) by the U.S. Centers for Disease Control and Prevention (CDC) (CDC, 2013b) . Initially confined to healthcare facilities, MRSA has since become increasingly prevalent in the broader population in both the United States and Europe (Chambers, 2001; Naimi et al., 2003; Zetola et al., 2005; Hetem et al., 2012; Kouyos et al., 2013; Tosas Auguet et al., 2016) . This entwined transmission among hospitals and the community has obscured understanding of the dynamics and persistence of MRSA. Further, MRSA can colonize patients without symptoms for years, during which it can be transmitted stealthily (Cooper et al., 2004a) . These epidemiological features have greatly complicated its control and elimination.