Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae
Objectives: To project future antimicrobial resistance (AMR) in Escherichia coli and Klebsiella pneumoniae. Methods: Mixed linear models were constructed from a sample of countries with AMR data in the ResistanceMap database. Inverse probability weighting methods were used to account for countries w...
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| Format: | Article |
| Language: | English |
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Elsevier
2018-03-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971218300110 |
| _version_ | 1819207694401142784 |
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| author | Gerardo Alvarez-Uria Sumanth Gandra Siddhartha Mandal Ramanan Laxminarayan |
| author_facet | Gerardo Alvarez-Uria Sumanth Gandra Siddhartha Mandal Ramanan Laxminarayan |
| author_sort | Gerardo Alvarez-Uria |
| collection | DOAJ |
| description | Objectives: To project future antimicrobial resistance (AMR) in Escherichia coli and Klebsiella pneumoniae. Methods: Mixed linear models were constructed from a sample of countries with AMR data in the ResistanceMap database. Inverse probability weighting methods were used to account for countries without AMR data. Results: The estimated prevalence of AMR in 2015 was 64.5% (95% confidence interval (CI) 42–87%) for third-generation cephalosporin-resistant (3GCR) Escherichia coli, 5.8% (95% CI 1.8–9.7%) for carbapenem-resistant (CR) E. coli, 66.9% (95% CI 47.1–86.8%) for 3GCR Klebsiella pneumoniae, and 23.4% (95% CI 7.4–39.4%) for CR K. pneumoniae. The projected AMR prevalence in 2030 was 77% (95% CI 55–99.1%) for 3GCR E. coli, 11.8% (95% CI 3.7–19.9%) for CR E. coli, 58.2% (95% CI 50.2–66.1%) for 3GCR K. pneumoniae, and 52.8% (95% CI 16.3–89.3%) for CR K. pneumoniae. Conclusions: The models suggest that third-generation cephalosporins and carbapenems could be ineffective against a sizeable proportion of infections by E. coli and K. pneumoniae in most parts of the world by 2030, supporting both the need to enhance stewardship efforts and to prioritize research and development of new antibiotics for resistant Enterobacteriaceae. Keywords: Drug resistance, Forecasting, Enterobacteriaceae infections, Regression |
| first_indexed | 2024-12-23T05:27:34Z |
| format | Article |
| id | doaj.art-ef6e7d3c58e640a489da927b1c4ae754 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-23T05:27:34Z |
| publishDate | 2018-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-ef6e7d3c58e640a489da927b1c4ae7542022-12-21T17:58:33ZengElsevierInternational Journal of Infectious Diseases1201-97122018-03-01685053Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniaeGerardo Alvarez-Uria0Sumanth Gandra1Siddhartha Mandal2Ramanan Laxminarayan3Department of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, AP, IndiaCenter for Disease Dynamics, Economics & Policy, New Delhi, India; Department of Management Science, University of Strathclyde, Glasgow, UKPublic Health Foundation of India, Gurugram, IndiaCenter for Disease Dynamics, Economics & Policy, New Delhi, India; Department of Management Science, University of Strathclyde, Glasgow, UK; Princeton Environmental Institute, Princeton, NJ, USA; Corresponding author at: Center for Disease Dynamics, Economics & Policy, 1400 Eye Street NW, Suite 500, Washington, DC, 20005, USA.Objectives: To project future antimicrobial resistance (AMR) in Escherichia coli and Klebsiella pneumoniae. Methods: Mixed linear models were constructed from a sample of countries with AMR data in the ResistanceMap database. Inverse probability weighting methods were used to account for countries without AMR data. Results: The estimated prevalence of AMR in 2015 was 64.5% (95% confidence interval (CI) 42–87%) for third-generation cephalosporin-resistant (3GCR) Escherichia coli, 5.8% (95% CI 1.8–9.7%) for carbapenem-resistant (CR) E. coli, 66.9% (95% CI 47.1–86.8%) for 3GCR Klebsiella pneumoniae, and 23.4% (95% CI 7.4–39.4%) for CR K. pneumoniae. The projected AMR prevalence in 2030 was 77% (95% CI 55–99.1%) for 3GCR E. coli, 11.8% (95% CI 3.7–19.9%) for CR E. coli, 58.2% (95% CI 50.2–66.1%) for 3GCR K. pneumoniae, and 52.8% (95% CI 16.3–89.3%) for CR K. pneumoniae. Conclusions: The models suggest that third-generation cephalosporins and carbapenems could be ineffective against a sizeable proportion of infections by E. coli and K. pneumoniae in most parts of the world by 2030, supporting both the need to enhance stewardship efforts and to prioritize research and development of new antibiotics for resistant Enterobacteriaceae. Keywords: Drug resistance, Forecasting, Enterobacteriaceae infections, Regressionhttp://www.sciencedirect.com/science/article/pii/S1201971218300110 |
| spellingShingle | Gerardo Alvarez-Uria Sumanth Gandra Siddhartha Mandal Ramanan Laxminarayan Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae International Journal of Infectious Diseases |
| title | Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae |
| title_full | Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae |
| title_fullStr | Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae |
| title_full_unstemmed | Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae |
| title_short | Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae |
| title_sort | global forecast of antimicrobial resistance in invasive isolates of escherichia coli and klebsiella pneumoniae |
| url | http://www.sciencedirect.com/science/article/pii/S1201971218300110 |
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