Metapopulation ecology links antibiotic resistance, consumption, and patient transfers in a network of hospital wards.
E. coli
Enterobacter cloacae
Klebsiella pneumoniae
MRSA
antibiotic stewardship
antimicrobial resistance
ecology
infection control
infectious disease
microbiology
Journal
eLife
ISSN: 2050-084X
Titre abrégé: Elife
Pays: England
ID NLM: 101579614
Informations de publication
Date de publication:
27 10 2020
27 10 2020
Historique:
received:
30
12
2019
accepted:
12
10
2020
pubmed:
28
10
2020
medline:
17
3
2021
entrez:
27
10
2020
Statut:
epublish
Résumé
Antimicrobial resistance (AMR) is a global threat. A better understanding of how antibiotic use and between-ward patient transfers (or connectivity) impact population-level AMR in hospital networks can help optimize antibiotic stewardship and infection control strategies. Here, we used a metapopulation framework to explain variations in the incidence of infections caused by seven major bacterial species and their drug-resistant variants in a network of 357 hospital wards. We found that ward-level antibiotic consumption volume had a stronger influence on the incidence of the more resistant pathogens, while connectivity had the most influence on hospital-endemic species and carbapenem-resistant pathogens. Piperacillin-tazobactam consumption was the strongest predictor of the cumulative incidence of infections resistant to empirical sepsis therapy. Our data provide evidence that both antibiotic use and connectivity measurably influence hospital AMR. Finally, we provide a ranking of key antibiotics by their estimated population-level impact on AMR that might help inform antimicrobial stewardship strategies.
Identifiants
pubmed: 33106223
doi: 10.7554/eLife.54795
pii: 54795
pmc: PMC7690951
doi:
pii:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Fondation Innovations en Infectiologie
ID : R18037CC
Pays : International
Organisme : French Laboratory of Excellence project ECOFECT
ID : ANR-11-LABX-0048
Pays : International
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020, Shapiro et al.
Déclaration de conflit d'intérêts
JS, GL, AM, PG, AL, MM, JS, BL, OD, FL, GL, CC, SC, FV, JF, JR No competing interests declared
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