DYNAMICAL SYSTEM ANALYSIS OF STAPHYLOCOCCUS EPIDERMIDIS BLOODSTREAM INFECTION

被引:16
作者
Chung, Hangyul M. [1 ,2 ]
Cartwright, Megan M. [1 ,2 ]
Bortz, David M. [3 ]
Jackson, Trachette L. [2 ,4 ]
Younger, John G. [1 ,2 ]
机构
[1] Univ Michigan, Dept Emergency Med, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Ctr Computat Med & Biol, Ann Arbor, MI 48109 USA
[3] Univ Colorado, Dept Appl Math, Boulder, CO 80309 USA
[4] Univ Michigan, Dept Math, Ann Arbor, MI 48109 USA
来源
SHOCK | 2008年 / 30卷 / 05期
关键词
Bacteremia; immunocompromise; mathematical models; statistical methods;
D O I
10.1097/SHK.0b013e31816a0b77
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Unlike many localized infections, the development and resolution of bacteremia involves physical and immunological interactions between many anatomic sites. In an effort to better understand these interactions, we developed a computational model of bacteremia as a dynamical system fashioned after multicompartmental pharmacodynamic models, incorporating bacterial proliferation and clearance in the blood, liver, spleen, and lungs, and the transport of pathogens between these sites. A system of four first-order homogeneous ODEs was developed. Blood and organ bacterial burdens were measured at various time points from 3 to 48 h postinoculation using an LD25 murine model of Staphylococcus epidermidis bacteremia. Using these empiric data, solutions to the mathematical model were recovered. A bootstrap resampling method was used to generate 95% confidence intervals around the solved parameters. The validity of the model was examined in parallel experiments using animals acutely immunocompromised with cyclophosphamide; the model captured abnormalities in bacterial partitioning previously described with this antineoplastic agent. Lastly, the approach was used to explore possible benefits to clinically observed hyperdynamic blood flow during sepsis: in simulation, normal mice, but not those treated with cyclophosphamide, enjoyed significantly more rapid bacterial clearance from the bloodstream under hyperdynamic conditions.
引用
收藏
页码:518 / 526
页数:9
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