The emergence of drug-resistant strains of bacteria is an increasing threat to society, especially in hospital settings. Many antibiotics that were formerly effective in combating bacterial infections in hospital patients are no longer effective because of the evolution of resistant strains, which compromises medical care worldwide. In this article, we formulate a two-level population model to quantify key elements in nosocomial (hospital-acquired) infections. At the bacteria level, patients infected with these strains generate both nonresistant and resistant bacteria. At the patient level, susceptible patients are infected by infected patients at rates proportional to the total bacteria load of each strain present in the hospital. The objectives of this paper are to analyze the dynamic elements of nonresistant and resistant bacteria strains in epidemic populations in hospital environments and to provide understanding of measures to avoid the endemicity of resistant antibiotic strains.
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