TY - JOUR
T1 - Metapopulation ecology links antibiotic resistance, consumption, and patient transfers in a network of hospital wards
AU - Shapiro, Julie Teresa
AU - Leboucher, Gilles
AU - Myard-Dury, Anne Florence
AU - Girardo, Pascale
AU - Luzatti, Anatole
AU - Mary, Mélissa
AU - Sauzon, Jean François
AU - Lafay, Bénédicte
AU - Dauwalder, Olivier
AU - Laurent, Frédéric
AU - Lina, Gérard
AU - Chidiac, Christian
AU - Couray-Targe, Sandrine
AU - Vandenesch, François
AU - Flandrois, Jean Pierre
AU - Rasigade, Jean Philippe
N1 - Publisher Copyright:
© 2020, eLife Sciences Publications Ltd. All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Antimicrobial resistance (AMR) is a global threat. A better understanding of how antibiotic use and between-ward patient transfers (or connectivity) impact population-level AMR in hospital networks can help optimize antibiotic stewardship and infection control strategies. Here, we used a metapopulation framework to explain variations in the incidence of infections caused by 7 major bacterial species and their drug-resistant variants in a network of 357 hospital wards. We found that ward-level antibiotic consumption volume had a stronger influence on the incidence of the more resistant pathogens, while connectivity had the most influence on hospital-endemic species and carbapenem-resistant pathogens. Piperacillin-tazobactam consumption was the strongest predictor of the cumulative incidence of infections resistant to empirical sepsis therapy. Our data provide evidence that both antibiotic use and connectivity measurably influence hospital AMR. Finally, we provide a ranking of key antibiotics by their estimated population-level impact on AMR that might help inform antimicrobial stewardship strategies.
AB - Antimicrobial resistance (AMR) is a global threat. A better understanding of how antibiotic use and between-ward patient transfers (or connectivity) impact population-level AMR in hospital networks can help optimize antibiotic stewardship and infection control strategies. Here, we used a metapopulation framework to explain variations in the incidence of infections caused by 7 major bacterial species and their drug-resistant variants in a network of 357 hospital wards. We found that ward-level antibiotic consumption volume had a stronger influence on the incidence of the more resistant pathogens, while connectivity had the most influence on hospital-endemic species and carbapenem-resistant pathogens. Piperacillin-tazobactam consumption was the strongest predictor of the cumulative incidence of infections resistant to empirical sepsis therapy. Our data provide evidence that both antibiotic use and connectivity measurably influence hospital AMR. Finally, we provide a ranking of key antibiotics by their estimated population-level impact on AMR that might help inform antimicrobial stewardship strategies.
UR - http://www.scopus.com/inward/record.url?scp=85095706174&partnerID=8YFLogxK
U2 - 10.7554/eLife.54795
DO - 10.7554/eLife.54795
M3 - Article
C2 - 33106223
AN - SCOPUS:85095706174
SN - 2050-084X
VL - 9
SP - 1
EP - 42
JO - eLife
JF - eLife
ER -