RT Journal Article
SR Electronic
T1 Metapopulation ecology links antibiotic resistance, consumption and patient transfers in a network of hospital wards
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 771790
DO 10.1101/771790
A1 Julie Teresa Shapiro
A1 Gilles Leboucher
A1 Anne-Florence Myard-Dury
A1 Pascale Girardo
A1 Anatole Luzatti
A1 Mélissa Mary
A1 Jean-François Sauzon
A1 Bénédicte Lafay
A1 Olivier Dauwalder
A1 Frédéric Laurent
A1 Gérard Lina
A1 Christian Chidiac
A1 Sandrine Couray-Targe
A1 François Vandenesch
A1 Jean-Pierre Flandrois
A1 Jean-Philippe Rasigade
YR 2019
UL http://biorxiv.org/content/early/2019/09/19/771790.abstract
AB Antimicrobial resistance (AMR) is a global threat. A better understanding of how antibiotic use and between ward patient transfers (or connectivity) impact hospital AMR can help optimize antibiotic stewardship and infection control strategies. Here, we used metapopulation ecology to explain variations in infection incidences of 17 ESKAPE pathogen variants in a network of 357 hospital wards. Multivariate models identified the strongest influence of ward-level antibiotic use on more resistant variants, and of connectivity on nosocomial species and carbapenem-resistant variants. Pairwise associations between infection incidence and the consumption of specific antibiotics were significantly stronger when such associations represented a priori AMR selection, suggesting that AMR evolves within the network. Piperacillin-tazobactam consumption was the strongest predictor of the cumulative incidence of infections resistant to empirical sepsis therapy. Our data establish that both antibiotic use and connectivity measurably influence hospital AMR and provide a ranking of key antibiotics by their impact on AMR.