A mathematical model for predicting the development of bacterial resistance based on the relationship between the level of antimicrobial resistance and the volume of antibiotic consumption

Arepeva, Maria A.

doi:10.26226/morressier.56d5ba2cd462b80296c96941

Cited by 7 publications

(10 citation statements)

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“…Underexposure to antibiotics, higher incidences of co-occurrence ARG subtypes of the same type may generally re ect selective pressure exerted by the same antibiotics in sewage, as our results showed, antibiotic consumption of a few months before in uenced the abundance of ARGs in sewage later, with the peak of ARGs lagging that of antibiotics use for 2-6 months. Previous studies showed that Cephalosporin consumption of 7-10 months before had a signi cant in uence on resistance, while consumption of Penicillin / Beta-lactamase inhibitor produced resistance without delay [30]. The possible explanation for this phenomenon may be that different antibiotics have different selective capabilities [31], and the abundance of ARGs is driven by complex interplays of different environmental, antibiotic types, and anthropogenic variables, rather than being related to any single factor.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance Genes and Bacteria Detected in Hospital Sewage May Provide Valuable Information in Clinical Antimicrobial Resistance

Cai¹,

Sun²,

Yao³

et al. 2020

Preprint

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Aim: Clinical antimicrobial resistance (AMR) is a significant threat to public health, which is often unclear due to representative data from human populations that are challenging to obtain. Study the associations between consumption of antibiotics and antimicrobial resistance bacteria or genes (ARB or ARGs) that will benefit from elucidating the AMR. Methods: The details of antibiotics usage were calculated based on the actual consumption in the target hospital, ARB was detected by culture method, and ARGs were evaluated by metagenomics. Results: Our study revealed that culture-based single-indicator-strain approaches only capture the AMR in 16.17% infectious samples. 1573 bacterial species and 885 types of ARGs were found in the hospital sewage. The consumption of antibiotics influences the resistance profiles that were significant in E.coli, but the strength varies among bacteria. In all ARGs group, ARGs of aminoglycosides was the most common, followed by sulfonamide, tetracycline, phenicol, macrolides, and quinolones, comprising to 82.6% of all ARGs. Five hundred nineteen pairs of ARGs and bacterial species showed a significant correlation (r > 0.8). The co-occurrence patterns of bacteria- ARGs mirrors the AMR of the clinic. Antibiotic usage will affect the abundance of ARG in sewage, with a hysteresis effect. Conclusion: The ARGs- bacteria co-occurrence patterns from wastewater could be a valuable bio-indicator to reflect the emergence of ARB in the future. Developing a predictive risk model of AMR on this basis will facilitate the rational use of antibiotics.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance Genes and Bacteria Detected in Hospital Sewage May Provide Valuable Information in Clinical Antimicrobial Resistance

Cai¹,

Sun²,

Yao³

et al. 2020

Preprint

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“…Динамика антибиотикорезистентности: структура математической модели. Прогнозирование резистент ности осуществляли с помощью регрессионной модели, разработанной и представленной нами ранее [7,8]…”

Section: материалы и методыunclassified

“…Зная текущую структуру потре бления АМП и существующие уровни резистентности возбудителей, можно спрогнозировать изменение ре зистентности за определенный период времени и рас считать динамику затрат, связанных с изменением доли резистентных штаммов. Построенная математическая модель также позволяет найти оптимальный уровень потребления АМП, при котором риски развития рези стентности E. coli минимизируются [7,8]. Данные по прогнозированию резистентности при различных уров нях потребления АМП представлены в Таблице 5.…”

Section: результатыunclassified

“…В предыдущем исследовании ДАРМИС, которое проводилось в 2010 2011 гг., не было представлено данных о локальных уровнях резистентности [6]. Учитывая ограниченные данные о текущих локальных показателях резистентно сти, крайне важной является возможность математиче ского моделирования [7,8]. Кроме уровня резистент ности, при выборе режимов эмпирической терапии инфекций необходимо учитывать их экономическую це лесообразность и безопасность [9,10].…”

Section: Introductionunclassified

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Calculation of the optimal structure of antibiotic consumption in a hospital based on the predicted antimicrobial resistance in the treatment of uncomplicated acute pyelonephritis

Gomon

Arepeva

Колбин

et al. 2018

CMAC

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Objective. To select an optimal (in terms of influence on the antibiotic resistance level) and cost-effective structure of antibiotic consumption in a hospital in the management of patients with acute uncomplicated pyelonephritis. Materials and Methods. Based on the literature data as well as a real practice of antibiotic administration, the cost of treatment of an acute uncomplicated pyelonephritis case with different regimens of initial antimicrobial treatment was calculated. Using mathematical modeling, changes in antimicrobial resistance of E. coli taking into consideration the current practice of the antibiotic administration were predicted. The optimal mode of antibiotic consumption in which antimicrobial resistance level would be minimal was predicted. Results. The current mode of antibiotic consumption where fluoroquinolones, 3rd generation cephalosporins, and penicillin/beta-lactamase inhibitor combinations account for more than 60% of consumption will lead to an increase in the proportion of extended-spectrum beta-lactamase (ESBL) producing E. coli by 14% over a 5-year period. At the same time, alternative (optimal) mode of antibiotic consumption (i.e. almost complete withdrawal of penicillin/beta-lactamase inhibitor combinations and fluoroquinolones from the clinical practice with the concomitant increase in consumption of carbapenems by 30% and increase in consumption of 3rd generation cephalosporins by 20%) will lead to a decrease in the proportion of ESBLproducing E. coli by 7% over 5 years. The cost of an acute uncomplicated pyelonephritis case with the current mode of antibiotic consumption will be increasing due to an increase in the proportion of ESBLproducing E. coli. At the same time, the alternative (optimal) mode of antibiotic consumption will lead to a significant reduction in the proportion of ESBL-producing E. coli. Conclusions. Use of mathematical modeling gives the opportunity to calculate changes in antimicrobial resistance of pathogens and choose the optimal mode of antibiotic consumption to reduce resistance levels.

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“…В настоящее время отсутствуют сведения о динамике резистентности внегоспитальных штаммов бактерий рода Enterobacteriacea в РФ. Тем не менее существуют возможности математического моделирования, позволяющие прогнозировать изменения уровня резистентности возбудителей на фоне текущего потребления антибактериальных препаратов [27]. Подобные сведения крайне важны и позволят более точно прогнозировать не только затраты, связанные с неадекватностью стартового режима терапии, но и экономические последствия «параллельного ущерба» текущей практики назначения антибактериальных препаратов при лечении инфекций различных локализаций.…”

Section: результаты исследования и их обсуждениеunclassified

Problems of Complicated Intra-Abdominal Infection’s Antibacterial Treatment in Multidisciplinary Hospitals

Гомон¹,

Kolbin²,

Балыкина³

et al. 2018

Uč. zap. St.-Peterbg. gos. med. univ. im. Akad. I.P. Pavlova

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A mathematical model for predicting the development of bacterial resistance based on the relationship between the level of antimicrobial resistance and the volume of antibiotic consumption

Cited by 7 publications

References 0 publications

Antimicrobial Resistance Genes and Bacteria Detected in Hospital Sewage May Provide Valuable Information in Clinical Antimicrobial Resistance

Antimicrobial Resistance Genes and Bacteria Detected in Hospital Sewage May Provide Valuable Information in Clinical Antimicrobial Resistance

Calculation of the optimal structure of antibiotic consumption in a hospital based on the predicted antimicrobial resistance in the treatment of uncomplicated acute pyelonephritis

Problems of Complicated Intra-Abdominal Infection’s Antibacterial Treatment in Multidisciplinary Hospitals

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