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Potential impact of novel diagnostics and treatments on the burden of antibiotic resistant in Escherichia coli

Pierre Nouvellet, J.V. Robotham, N.R. Naylor, N. Woodford, Neil M. Ferguson
doi: https://doi.org/10.1101/052944
Pierre Nouvellet
1National Institute for Health Research Health Protection Research Unit in Modelling Methodology, Imperial College London, Faculty of Medicine, London, UK.
2MRC Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London, UK.
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J.V. Robotham
3National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Faculty of Medicine, London, UK.
4Modelling and Economics Unit, Public Health England, Colindale, London, UK
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N.R. Naylor
3National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Faculty of Medicine, London, UK.
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N. Woodford
3National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Faculty of Medicine, London, UK.
5Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, UK.
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Neil M. Ferguson
1National Institute for Health Research Health Protection Research Unit in Modelling Methodology, Imperial College London, Faculty of Medicine, London, UK.
2MRC Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London, UK.
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Abstract

The rising threat of antibiotic resistance in Europe and beyond is of increasing concern and is prompting renewed effort to better understand and mitigate their impact. Escherichia Coli blood stream infections are a more major concern in Europe given their incidence and severe associated outcomes. Additionally the level of 3rd generation cephalosporins and carbapenems resistance among those bacteraemia has significantly increased, limiting available treatment options. We estimated the current burden associated with E. coli blood stream infections in Europe at 17,000 (95%CI [8,000; 30,000]) excess deaths and 960,000 (95%CI [600,000; 1,450,000]) extra hospital bed days. From those, the contribution due to 3rd generation cephalosporins and carbapenems resistant strains reached 6,000 (95%CI [2,000; 12,000]) excess deaths, and 200,000 (95%CI [76,000; 420,000]) extra hospital bed stay. In the worst case scenario, we estimated the burden of E. coli blood stream infection in 2026 could increase over 4-fold, mostly resulting from an increase in the level of resistance rather than an increase in the incidence of blood stream infections. Finally, we estimated that the impact of combined novel diagnostics and treatments could substantially reduce the excess mortality by 18.5% to 55.5%, and length of stay by 13.2% to 75.6%.

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The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.
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Posted May 13, 2016.
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Potential impact of novel diagnostics and treatments on the burden of antibiotic resistant in Escherichia coli
Pierre Nouvellet, J.V. Robotham, N.R. Naylor, N. Woodford, Neil M. Ferguson
bioRxiv 052944; doi: https://doi.org/10.1101/052944
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Potential impact of novel diagnostics and treatments on the burden of antibiotic resistant in Escherichia coli
Pierre Nouvellet, J.V. Robotham, N.R. Naylor, N. Woodford, Neil M. Ferguson
bioRxiv 052944; doi: https://doi.org/10.1101/052944

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