The goal of this project is to create a new agent-based model of methicillin resistant Staphylococcus aureus (MRSA), an antibiotic-resistant bacterium that most commonly causes skin infections but can cause serious and fatal infections of any organ. During the past decade, MRSA has spread exponentially and is a serious public health threat. New strains of MRSA have rapidly evolved in the community, interacting with MRSA in the healthcare environment, which first appeared almost 50 years ago. MRSA has a number of distinctive features that represent challenges and opportunities for agent-based modeling. Our model will allow agents to adapt their behavior dependent on disease conditions and perceptions of risk. The model will include theoretically based and empirically derived variables representing behavioral features of the population and the healthcare system that are relevant to infectious disease transmission and control. These will include variables representing social networks relevant for disease transmission, social networks relevant for information transfer and individual variation in propensity to follow health recommendations. This project brings together investigators with unique interdisciplinary expertise: epidemiology, MRSA, social sciences, Bayesian statistics, agent-based modeling, high performance computing, and public health. Specifically, we will develop a flexible agent-based model scaling up in stages to the population of the Chicago metropolitan area. The 1st stage will include a corridor across the south side of Chicago and adjoining suburbs, an area in which MRSA has been a serious problem and has been extensively studied both in community and healthcare settings. Guided by our research team's expertise in MRSA, our model will capture features of the environment and characteristics of the individual that are particularly salient for MRSA epidemiology. We will develop variables to represent innate individual MRSA risk, location-specific MRSA transmission probabilities, and contamination of fomites (inanimate objects on which MRSA is present). Using the model, we will test hypotheses about factors contributing to MRSA spread. We will determine which clinical, public health and institutional measures are likely to have the greatest impact on the epidemic. An important component of the proposed work will be to study variation in model outcomes (i.e., model uncertainty), and the effect of changes in model parameters, network specifications, and other variables on this variation. To do this, we shall use high-performance computing capabilities at the University of Chicago and Argonne National Laboratory to run individual model configurations thousands of times. Public Health Relevance: Computational models have been used to understand the effectiveness of different types of control interventions for infectious diseases. In this project, we model the spread and control of methicillin resistant Staphylococcus aureus (MRSA), an antibiotic-resistant bacterium that now kills more people each year in the U.S. than AIDS. Our models, which will introduce variables representing variation in infection-related behavior, will help identify best practices for infection control and treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01GM087729-04
Application #
8260512
Study Section
Special Emphasis Panel (ZGM1-CBCB-5 (MI))
Program Officer
Sheeley, Douglas
Project Start
2009-05-08
Project End
2014-04-30
Budget Start
2012-05-01
Budget End
2013-04-30
Support Year
4
Fiscal Year
2012
Total Cost
$665,590
Indirect Cost
$272,521
Name
University of Chicago
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
005421136
City
Chicago
State
IL
Country
United States
Zip Code
60637
David, Michael Z; Siegel, Jane D; Henderson, Janet et al. (2014) Hand and nasal carriage of discordant Staphylococcus aureus isolates among urban jail detainees. J Clin Microbiol 52:3422-5
David, Michael Z; Cadilla, Adriana; Boyle-Vavra, Susan et al. (2014) Replacement of HA-MRSA by CA-MRSA infections at an academic medical center in the midwestern United States, 2004-5 to 2008. PLoS One 9:e92760
Wilder, Jocelyn R; Wegener, Duane T; David, Michael Z et al. (2014) A national survey of skin infections, care behaviors and MRSA knowledge in the United States. PLoS One 9:e104277
David, Michael Z; Taylor, Alexis; Lynfield, Ruth et al. (2013) Comparing pulsed-field gel electrophoresis with multilocus sequence typing, spa typing, staphylococcal cassette chromosome mec (SCCmec) typing, and PCR for panton-valentine leukocidin, arcA, and opp3 in methicillin-resistant Staphylococcus aureus isolates J Clin Microbiol 51:814-9
Dukic, Vanja M; Lauderdale, Diane S; Wilder, Jocelyn et al. (2013) Epidemics of community-associated methicillin-resistant Staphylococcus aureus in the United States: a meta-analysis. PLoS One 8:e52722
Elderd, Bret D; Dwyer, Greg; Dukic, Vanja (2013) Population-level differences in disease transmission: a Bayesian analysis of multiple smallpox epidemics. Epidemics 5:146-56
Lee, B Y; Singh, A; David, M Z et al. (2013) The economic burden of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). Clin Microbiol Infect 19:528-36
Armbruster, Benjamin; Roy, Sourya; Kapur, Abhinav et al. (2013) Sex role segregation and mixing among men who have sex with men: implications for biomedical HIV prevention interventions. PLoS One 8:e70043
David, Michael Z; Rudolph, Karen M; Hennessy, Thomas W et al. (2012) MRSA USA300 at Alaska Native Medical Center, Anchorage, Alaska, USA, 2000-2006. Emerg Infect Dis 18:105-8
Dukic, Vanja M; David, Michael Z; Lauderdale, Diane S (2011) Internet queries and methicillin-resistant Staphylococcus aureus surveillance. Emerg Infect Dis 17:1068-70

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