Send more data: a systematic review of mathematical models of antimicrobial resistance

Birkegård, Anna Camilla; Halasa, Tariq Hisham Beshara; Toft, Nils; Folkesson, Anders; Græsbøll, Kaare

doi:10.1186/s13756-018-0406-1

Cited by 47 publications

(48 citation statements)

References 70 publications

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“…Here, we undertake a systematic review to assess how population-level mathematical and computational modeling has been applied in the field of AMR over a period of 11 years (2006–2016). Previous reviews of AMR modeling were either completed some time ago [10, 11], only applied to a specific subset of AMR, such as HCAIs [12, 13], or focused on acquired resistance [14]. Our goals in this study were to (1) identify the predominant pathogens, populations, and interventions studied; (2) highlight recent advances in the field; (3) assess the influence of the research; and (4) identify gaps in both modeling of AMR and data availability.…”

Section: Introductionmentioning

confidence: 99%

Population-level mathematical modeling of antimicrobial resistance: a systematic review

Niewiadomska

Jayabalasingham

Seidman

et al. 2019

BMC Med

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Background Mathematical transmission models are increasingly used to guide public health interventions for infectious diseases, particularly in the context of emerging pathogens; however, the contribution of modeling to the growing issue of antimicrobial resistance (AMR) remains unclear. Here, we systematically evaluate publications on population-level transmission models of AMR over a recent period (2006–2016) to gauge the state of research and identify gaps warranting further work. Methods We performed a systematic literature search of relevant databases to identify transmission studies of AMR in viral, bacterial, and parasitic disease systems. We analyzed the temporal, geographic, and subject matter trends, described the predominant medical and behavioral interventions studied, and identified central findings relating to key pathogens. Results We identified 273 modeling studies; the majority of which (> 70%) focused on 5 infectious diseases (human immunodeficiency virus (HIV), influenza virus, Plasmodium falciparum (malaria), Mycobacterium tuberculosis (TB), and methicillin-resistant Staphylococcus aureus (MRSA)). AMR studies of influenza and nosocomial pathogens were mainly set in industrialized nations, while HIV, TB, and malaria studies were heavily skewed towards developing countries. The majority of articles focused on AMR exclusively in humans (89%), either in community (58%) or healthcare (27%) settings. Model systems were largely compartmental (76%) and deterministic (66%). Only 43% of models were calibrated against epidemiological data, and few were validated against out-of-sample datasets (14%). The interventions considered were primarily the impact of different drug regimens, hygiene and infection control measures, screening, and diagnostics, while few studies addressed de novo resistance, vaccination strategies, economic, or behavioral changes to reduce antibiotic use in humans and animals. Conclusions The AMR modeling literature concentrates on disease systems where resistance has been long-established, while few studies pro-actively address recent rise in resistance in new pathogens or explore upstream strategies to reduce overall antibiotic consumption. Notable gaps include research on emerging resistance in Enterobacteriaceae and Neisseria gonorrhoeae ; AMR transmission at the animal-human interface, particularly in agricultural and veterinary settings; transmission between hospitals and the community; the role of environmental factors in AMR transmission; and the potential of vaccines to combat AMR. Electronic supplementary material The online version of this article (10.1186/s12916-019-1314-9) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Population-level mathematical modeling of antimicrobial resistance: a systematic review

Niewiadomska

Jayabalasingham

Seidman

et al. 2019

BMC Med

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“…Three classes of models were used to capture past trends and both linear and nonlinear relationships with covariates: exponential smoothing with an additive damped trend, mixed-effects linear regression and random forest. While mechanistic models of AMR emergence and spread could be a valuable addition to our ensemble [21,22], we did not find any that could inform forecasts at the national level for different countries and priority antibiotic-bacterium combinations [23] and therefore decided against using this approach. To forecast antibiotic consumption – defined as the number of standard units (the equivalent of one pill, capsule or ampoule) per 1,000 population – for each antibiotic class, we used country-specific exponential smoothing with an additive damped trend.…”

Section: Methodsmentioning

confidence: 99%

Resistance proportions for eight priority antibiotic-bacterium combinations in OECD, EU/EEA and G20 countries 2000 to 2030: a modelling study

et al. 2019

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Background Antimicrobial resistance is widely considered an urgent global health issue due to associated mortality and disability, societal and healthcare costs. Aim To estimate the past, current and projected future proportion of infections resistant to treatment for eight priority antibiotic-bacterium combinations from 2000 to 2030 for 52 countries. Methods We collated data from a variety of sources including ResistanceMap and World Bank. Feature selection algorithms and multiple imputation were used to produce a complete historical dataset. Forecasts were derived from an ensemble of three models: exponential smoothing, linear regression and random forest. The latter two were informed by projections of antibiotic consumption, out-of-pocket medical spending, populations aged 64 years and older and under 15 years and real gross domestic product. We incorporated three types of uncertainty, producing 150 estimates for each country-antibiotic-bacterium-year. Results Average resistance proportions across antibiotic-bacterium combinations could grow moderately from 17% to 18% within the Organisation for Economic Co-operation and Development (OECD; growth in 64% of uncertainty sets), from 18% to 19% in the European Union/European Economic Area (EU/EEA; growth in 87% of uncertainty sets) and from 29% to 31% in Group of Twenty (G20) countries (growth in 62% of uncertainty sets) between 2015 and 2030. There is broad heterogeneity in levels and rates of change across countries and antibiotic-bacterium combinations from 2000 to 2030. Conclusion If current trends continue, resistance proportions are projected to marginally increase in the coming years. The estimates indicate there is significant heterogeneity in resistance proportions across countries and antibiotic-bacterium combinations.

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“…Antibiotic resistance is a global concern because of its fast spread not only in human, but also in animal populations ( 1 – 3 ). A common feature for livestock production in the Nordic countries is the constant focus on prudent use of antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Prudent Use of Antibiotics in Dairy Cows: The Nordic Approach to Udder Health

et al. 2021

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Global concerns regarding bacterial antibiotic resistance demand prudent use of antibiotics in livestock production. Dairy production in the Nordic countries has a low consumption of antibiotics, while animal health, productivity and milk quality are at high levels. Here, we describe the basis of Nordic mastitis control and treatment strategies, as a model for production of high-quality milk with prudent use of antibiotics. We hope this will be beneficial for dairy producers and advisors in other countries and regions that consider limiting antibiotic use in cattle herds. In this perspectives paper we describe the dairy sector in the Nordic countries, and present regulatory aspects of antibiotic use, diagnostics and current guidelines for treatment of clinical mastitis as well as dry cow therapy. We also show summary statistics of udder health indicators in Denmark, Finland, Norway and Sweden, to illustrate the effects of the implemented udder health management practices.

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Send more data: a systematic review of mathematical models of antimicrobial resistance

Cited by 47 publications

References 70 publications

Population-level mathematical modeling of antimicrobial resistance: a systematic review

Population-level mathematical modeling of antimicrobial resistance: a systematic review

Resistance proportions for eight priority antibiotic-bacterium combinations in OECD, EU/EEA and G20 countries 2000 to 2030: a modelling study

Prudent Use of Antibiotics in Dairy Cows: The Nordic Approach to Udder Health

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