Identifying determinants of persistent MRSA bacteremia using mathematical modeling
Fig 3
Simulation of the models with vancomycin therapy.
(A) The selected parameter sets were used for simulation with vancomycin treatment and classified into resolving (RB) and persistent bacteremia (PB) as described in the algorithm. Vancomycin was administered when normal SA (N) exceeded 104 cfu/a.u. The models were judged as PB when the number of total SA (T) at 5 days post-treatment exceeded a detection limit under an assumption where positive bacteremia is observed when the number of SA at infection foci exceed a certain number (see text in details). The detection limit of bacteremia is set as 0.1 cfu/a.u. in this study under an assumption where relapse bacteremia is less in RB (see Fig 3B). The relapse bacteremia was determined when vancomycin was re-administered triggered by regrowth of SA after 1st vancomycin treatment. Four cases of typical simulations, RB no relapse, RB with relapse, PB no relapse and PB with relapse, are shown in the bottom. (B) Bar plots show the number of models with or without relapse for RB (left) and PB (right) over a range of detection limit from 0.001 to 10 cfu/a.u. A dotted line indicates the total number of models.