The impact of public health interventions on the future prevalence of ESBL-producing Klebsiella pneumoniae: a population based mathematical modelling study.
ESBL-producing Klebsiella pneumoniae
Mathematical model
Public health intervention
Resistance
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
23 May 2022
23 May 2022
Historique:
received:
09
06
2021
accepted:
03
05
2022
entrez:
23
5
2022
pubmed:
24
5
2022
medline:
26
5
2022
Statut:
epublish
Résumé
Future prevalence of colonization with extended-spectrum betalactamase (ESBL-) producing K. pneumoniae in humans and the potential of public health interventions against the spread of these resistant bacteria remain uncertain. Based on antimicrobial consumption and susceptibility data recorded during > 13 years in a Swiss region, we developed a mathematical model to assess the comparative effect of different interventions on the prevalence of colonization. Simulated prevalence stabilized in the near future when rates of antimicrobial consumption and in-hospital transmission were assumed to remain stable (2025 prevalence: 6.8% (95CI%:5.4-8.8%) in hospitals, 3.5% (2.5-5.0%) in the community versus 6.1% (5.0-7.5%) and 3.2% (2.3-4.2%) in 2019, respectively). When overall antimicrobial consumption was set to decrease by 50%, 2025 prevalence declined by 75% in hospitals and by 64% in the community. A 50% decline in in-hospital transmission rate led to a reduction in 2025 prevalence of 31% in hospitals and no reduction in the community. The best model fit estimated that 49% (6-100%) of observed colonizations could be attributable to sources other than human-to-human transmission within the geographical setting. Projections suggests that overall antimicrobial consumption will be, by far, the most powerful driver of prevalence and that a large fraction of colonizations could be attributed to non-local transmissions.
Sections du résumé
BACKGROUND
BACKGROUND
Future prevalence of colonization with extended-spectrum betalactamase (ESBL-) producing K. pneumoniae in humans and the potential of public health interventions against the spread of these resistant bacteria remain uncertain.
METHODS
METHODS
Based on antimicrobial consumption and susceptibility data recorded during > 13 years in a Swiss region, we developed a mathematical model to assess the comparative effect of different interventions on the prevalence of colonization.
RESULTS
RESULTS
Simulated prevalence stabilized in the near future when rates of antimicrobial consumption and in-hospital transmission were assumed to remain stable (2025 prevalence: 6.8% (95CI%:5.4-8.8%) in hospitals, 3.5% (2.5-5.0%) in the community versus 6.1% (5.0-7.5%) and 3.2% (2.3-4.2%) in 2019, respectively). When overall antimicrobial consumption was set to decrease by 50%, 2025 prevalence declined by 75% in hospitals and by 64% in the community. A 50% decline in in-hospital transmission rate led to a reduction in 2025 prevalence of 31% in hospitals and no reduction in the community. The best model fit estimated that 49% (6-100%) of observed colonizations could be attributable to sources other than human-to-human transmission within the geographical setting.
CONCLUSIONS
CONCLUSIONS
Projections suggests that overall antimicrobial consumption will be, by far, the most powerful driver of prevalence and that a large fraction of colonizations could be attributed to non-local transmissions.
Identifiants
pubmed: 35606726
doi: 10.1186/s12879-022-07441-z
pii: 10.1186/s12879-022-07441-z
pmc: PMC9125893
doi:
Substances chimiques
Anti-Bacterial Agents
0
beta-Lactamases
EC 3.5.2.6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
487Informations de copyright
© 2022. The Author(s).
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