Evolution of the Gram-Negative Antibiotic Resistance Spiral over Time: A Time-Series Analysis

• Prif Awduron: Hajnalka Tóth (Awdur), Gyula Buchholcz (Awdur), Adina Fésüs (Awdur), Bence Balázs (Awdur), József Bálint Nagy (Awdur), László Majoros (Awdur), Krisztina Szarka (Awdur), Gábor Kardos (Awdur)
• Fformat: Llyfr
• Cyhoeddwyd: MDPI AG, 2021-06-01T00:00:00Z.
• Pynciau: article
• Mynediad Ar-lein: Connect to this object online.
• Notes: 10.3390/antibiotics10060734; 2079-6382
• Keywords: vector autoregressive models; antibiotic consumption; antibiotic resistance; <i>Escherichia coli</i>; <i>Klebsiella</i> spp.; <i>Pseudomonas aeruginosa</i>; Therapeutics. Pharmacology; RM1-950
• Source: Antibiotics, Vol 10, Iss 6, p 734 (2021)

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 (<i>Escherichia coli</i>, <i>Klebsiella</i> spp., <i>Pseudomonas aeruginosa</i>, and <i>Acinetobacter baumannii</i>) resistant to cephalosporins or carbapenems were followed using vector autoregressive models sequentially built of time-series ending in <i>2015</i>, 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 <i>E. coli</i> 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 <i>A. baumannii</i>, were consistent throughout; associations in case of <i>Klebsiella</i> spp. were rarely found; associations in case of <i>P. aeruginosa</i> 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.