Control strategies for the dynamics of catheter-associated urinary tract infection
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Date
2026-02-21
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
Catheter-associated urinary tract infections (CAUTI) remain a major challenge in healthcare,
particularly among hospitalized and long term catheterized patients. This study develops a
deterministic compartmental model integrated with optimal control theory to evaluate the
effects of three time dependent interventions: public health education, alternative catheteriza
tion methods, and environmental hygiene control. Unlike existing CAUTI models, the proposed
framework explicitly incorporates both host to host transmission and environmental contami
nation, and quantifies intervention effectiveness using Pontryagin’s Maximum Principle and the
forward backward sweep algorithm. Simulation results show that the combined application of
all three controls yields the highest reduction in disease burden, decreasing infection preva
lence by approximately 82%, catheterized individuals by 75%, and environmental bacterial
concentration by 85% within 60 days compared to the uncontrolled scenario. Among dual
interventions, education with environmental hygiene achieves a 68% reduction in infections,
followed by catheterization reduction with hygiene at 63%. Education with catheterization
reduction produces a smaller decline of 49%. For individual interventions, environmental
hygiene is the most effective, achieving a 58% reduction, followed by education 46% and
catheterization minimization 32%. Closed-form threshold conditions derived from the effective
reproduction number (𝑒) provide practical bounds for control intensities needed to ensure
𝑒 < 1, particularly highlighting minimum hygiene requirements. Optimal-control profiles
indicate high initial intervention intensity that declines as infections decrease. Overall, the
findings demonstrate that integrated control especially when environmental hygiene is included
offers the most impactful strategy for r
Sustainable Development Goals
SDG-3: Good Health and Well-being
SDG-6: Clean Water and Sanitation
Keywords
Catheter-associated urinary tract infection, Intervention strategies, eFAST method, Environmental contamination, Hamiltonian function