Assessing the potential for improved predictive capacity of antimicrobial resistance in outpatient Staphylococcus aureus isolates using seasonal and spatial antibiograms.

IF 4.8 2区 医学 Q1 INFECTIOUS DISEASES
Margaret Carrel, Qianyi Shi, Gosia S Clore, Shinya Hasegawa, Matthew Smith, Eli N Perencevich, Michihiko Goto
{"title":"Assessing the potential for improved predictive capacity of antimicrobial resistance in outpatient Staphylococcus aureus isolates using seasonal and spatial antibiograms.","authors":"Margaret Carrel, Qianyi Shi, Gosia S Clore, Shinya Hasegawa, Matthew Smith, Eli N Perencevich, Michihiko Goto","doi":"10.1186/s13756-024-01388-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>While the use of cumulative susceptibility reports, antibiograms, is recommended for improved empiric therapy and antibiotic stewardship, the predictive ability of antibiograms has not been well-studied. While enhanced antibiograms have been shown to better capture variation in susceptibility profiles by characteristics such as infection site or patient age, the potential for seasonal or spatial variation in susceptibility has not been assessed as important in predicting likelihood of susceptibility.</p><p><strong>Methods: </strong>Utilizing Staphylococcus aureus isolates obtained in outpatient settings from a nationwide provider of care, the Veterans Health Administration, and a local provider of care, the University of Iowa Hospitals and Clinics, standard, seasonal and spatial antibiograms were created for five commonly used antibiotic classes: cephalosporins, clindamycin, macrolides, tetracycline, trimethoprim/sulfamethoxazole.</p><p><strong>Results: </strong>A total of 338,681 S. aureus isolates obtained in VHA outpatient settings from 2010 to 2019 and 6,817 isolates obtained in UIHC outpatient settings from 2014 to 2019 were used to generate and test antibiograms. Logistic regression modeling determined the capacity of these antibiograms to predict isolate resistance to each antibiotic class. All models had low predictive capacity, with areas under the curve of < 0.7.</p><p><strong>Conclusions: </strong>Standard antibiograms are poor in predicting S. aureus susceptibility to antibiotics often chosen by clinicians, and seasonal and spatial antibiograms do not provide an improved tool in anticipating non-susceptibility. These findings suggest that further refinements to antibiograms may be necessary to improve their utility in informing choice of effective antibiotic therapy.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"34"},"PeriodicalIF":4.8000,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10960453/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Antimicrobial Resistance and Infection Control","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13756-024-01388-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Background: While the use of cumulative susceptibility reports, antibiograms, is recommended for improved empiric therapy and antibiotic stewardship, the predictive ability of antibiograms has not been well-studied. While enhanced antibiograms have been shown to better capture variation in susceptibility profiles by characteristics such as infection site or patient age, the potential for seasonal or spatial variation in susceptibility has not been assessed as important in predicting likelihood of susceptibility.

Methods: Utilizing Staphylococcus aureus isolates obtained in outpatient settings from a nationwide provider of care, the Veterans Health Administration, and a local provider of care, the University of Iowa Hospitals and Clinics, standard, seasonal and spatial antibiograms were created for five commonly used antibiotic classes: cephalosporins, clindamycin, macrolides, tetracycline, trimethoprim/sulfamethoxazole.

Results: A total of 338,681 S. aureus isolates obtained in VHA outpatient settings from 2010 to 2019 and 6,817 isolates obtained in UIHC outpatient settings from 2014 to 2019 were used to generate and test antibiograms. Logistic regression modeling determined the capacity of these antibiograms to predict isolate resistance to each antibiotic class. All models had low predictive capacity, with areas under the curve of < 0.7.

Conclusions: Standard antibiograms are poor in predicting S. aureus susceptibility to antibiotics often chosen by clinicians, and seasonal and spatial antibiograms do not provide an improved tool in anticipating non-susceptibility. These findings suggest that further refinements to antibiograms may be necessary to improve their utility in informing choice of effective antibiotic therapy.

利用季节和空间抗生素图评估提高门诊金黄色葡萄球菌分离物抗菌药耐药性预测能力的潜力。
背景:虽然建议使用累积药敏报告(抗生素图)来改进经验疗法和抗生素管理,但抗生素图的预测能力尚未得到充分研究。虽然增强型抗生素图已被证明能更好地捕捉感染部位或患者年龄等特征在药敏谱中的变化,但尚未评估药敏的季节或空间变化在预测药敏可能性中的重要性:方法:利用从全国性医疗机构退伍军人健康管理局和地方性医疗机构爱荷华大学医院和诊所门诊获得的金黄色葡萄球菌分离株,为五类常用抗生素绘制了标准、季节和空间抗生素图谱:头孢菌素类、克林霉素类、大环内酯类、四环素类、三甲双胍/磺胺甲噁唑:从 2010 年到 2019 年,VHA 门诊共获得 338681 例金葡菌分离株,从 2014 年到 2019 年,UIHC 门诊共获得 6817 例分离株,这些分离株被用于生成和测试抗生素图谱。逻辑回归模型确定了这些抗生素图预测分离菌对每类抗生素耐药性的能力。所有模型的预测能力都很低,曲线下面积均为结论:标准抗生素图在预测金黄色葡萄球菌对临床医生经常选用的抗生素的敏感性方面效果不佳,而季节性和空间抗生素图在预测不敏感性方面并没有提供更好的工具。这些研究结果表明,有必要进一步完善抗生素图谱,以提高其在选择有效抗生素治疗方面的实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信