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001-es BibID:BIBFORM095312
Első szerző:Tóth Hajnalka (általános orvos)
Cím:Evolution of the Gram-Negative Antibiotic Resistance Spiral over Time : a Time-Series Analysis / Hajnalka Tóth, Gyula Buchholcz, Adina Fésüs, Bence Balázs, József Bálint Nagy, László Majoros, Krisztina Szarka, Gábor Kardos
Dátum:2021
ISSN:2079-6382
Megjegyzések:We followed up the interplay between antibiotic use and resistance over time in a tertiary-care hospital in Hungary. Dynamic relationships between monthly time-series of antibiotic consumption data (defined daily doses per 100 bed-days) and of incidence densities of Gram-negative bacteria (Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Acinetobacter baumannii) resistant to cephalosporins or carbapenems were followed using vector autoregressive models sequentially built of time-series ending in 2015, 2016, 2017, 2018, and 2019. Relationships with Gram-negative bacteria as a group were fairly stable across years. At species level, association of cephalosporin use and cephalosporin resistance of E. coli was shown in 2015?2017, leading to increased carbapenem use in these years. Association of carbapenem use and carbapenem resistance, as well as of carbapenem resistance and colistin use in case of A. baumannii, were consistent throughout; associations in case of Klebsiella spp. were rarely found; associations in case of P. aeruginosa varied highly across years. This highlights the importance of temporal variations in the interplay between changes in selection pressure and occurrence of competing resistant species.
Tárgyszavak:Orvostudományok Gyógyszerészeti tudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
vector autoregressive models
antibiotic consumption
antibiotic resistance
Escherichia coli
Klebsiella spp.
Pseudomonas aeruginosa
Acinetobacter baumannii
cephalosporin resistance
carbapenem resistance
colistin
Megjelenés:Antibiotics-Basel. - 10 : 6 (2021), p. 1-10. -
További szerzők:Buchholcz Gyula (1961-) (aneszteziológus) Fésüs Adina (1978-) (gyógyszerész) Balázs Bence (1991-) (PhD hallgató) Nagy József Bálint (1993-) (molekuláris biológus) Majoros László (1966-) (szakorvos, klinikai mikrobiológus) Szarka Krisztina (1971-) (molekuláris biológus, mikrobiológus) Kardos Gábor (1974-) (szakorvos, klinikai mikrobiológus)
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001-es BibID:BIBFORM076404
035-os BibID:(WoS)000490004300020 (Scopus)85070814450
Első szerző:Tóth Hajnalka (általános orvos)
Cím:Utilization of vector autoregressive and linear transfer models to follow up the antibiotic resistance spiral in Gram-negative bacteria from cephalosporin consumption to colistin resistance / Hajnalka Tóth, Adina Fésűs, Orsolya Kungler-Gorácz, Bence Balázs, László Majoros, Krisztina Szarka, Gábor Kardos
Dátum:2019
ISSN:1058-4838
Megjegyzések:BACKGROUND: Increasing antibiotic resistance may reciprocally affect consumption and lead to using broader-spectrum alternatives; a vicious cycle that may gradually limit therapeutic options. The study aims at demonstrating the abovementioned vicious cycle in Gram-negative bacteria and at showing the utility of vector autoregressive (VAR) models for analysis of time-series in explanatory and dependent roles simultaneously. METHODS: Monthly drug consumption data in defined daily doses per 100 bed-days and incidence densities of Gram-negative bacteria (Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa and Acinetobacterbaumannii) resistant to cephalosporins or to carbapenems were analysed using VAR models. These were compared to linear transfer models used earlier. RESULTS: In case of all Gram-negative bacteria, cephalosporin consumption led to increasing cephalosporin resistance, which provoked carbapenem use and consequent carbapenem resistance, and finally increased colistin consumption, exemplifying the vicious cycle. Different species were involved in different manner, e.g. cephalosporin resistant Klebsiella spp. provoked carbapenem use less than E. coli or association between carbapenem resistance of P. aeruginosa and colistin use was weaker than in case of A. baumannii. Colistin use led to decreased carbapenem use and decreased carbapenem resistance of P. aeruginosa but not of A. baumannii. CONCLUSIONS: Vector autoregressive models allow analysis of consumption and resistance series in a bidirectional manner. The reconstructed resistance spiral involved cephalosporin use augmenting cephalosporin resistance primarily in E. coli. This led to increased carbapenem use, provoking spread of carbapenem resistant A. baumannii and consequent colistin use. Emergence of panresistance is fuelled by such antibiotic resistance spirals.
Tárgyszavak:Orvostudományok Gyógyszerészeti tudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
time-series analysis
antibiotic consumption
carbapenem resistance
Megjelenés:Clinical Infectious Diseases. - 69 : 8 (2019), p. 1410-1421. -
További szerzők:Fésüs Adina (1978-) (gyógyszerész) Kungler-Gorácz Orsolya (1985-) (gyógyszerész) Balázs Bence (1991-) (PhD hallgató) Majoros László (1966-) (szakorvos, klinikai mikrobiológus) Szarka Krisztina (1971-) (molekuláris biológus, mikrobiológus) Kardos Gábor (1974-) (szakorvos, klinikai mikrobiológus)
Pályázati támogatás:ÚNKP-17-2
ÚNKP
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