Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae

Gerardo Alvarez-Uria, Sumanth Gandra, Siddhartha Mandal, Ramanan Laxminarayan

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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.

LanguageEnglish
Pages50-53
Number of pages4
JournalInternational Journal of Infectious Diseases
Volume68
DOIs
Publication statusPublished - 1 Mar 2018

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Klebsiella pneumoniae
Carbapenems
Confidence Intervals
Escherichia coli
Cephalosporins
Escherichia coli Infections
Enterobacteriaceae
Linear Models
Databases
Anti-Bacterial Agents
Research

Keywords

  • drug resistance
  • enterobacteriaceae infections
  • forecasting
  • regression

Cite this

@article{89485b883c8049fa99a51c1d4050b71a,
title = "Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae",
abstract = "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.",
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Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae. / Alvarez-Uria, Gerardo; Gandra, Sumanth; Mandal, Siddhartha; Laxminarayan, Ramanan.

In: International Journal of Infectious Diseases, Vol. 68, 01.03.2018, p. 50-53.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae

AU - Alvarez-Uria, Gerardo

AU - Gandra, Sumanth

AU - Mandal, Siddhartha

AU - Laxminarayan, Ramanan

PY - 2018/3/1

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N2 - 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.

AB - 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.

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T2 - International Journal of Infectious Diseases

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SN - 1201-9712

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