Resistance Trend Estimation Using Regression Analysis to Enhance Antimicrobial Surveillance: A Multi-Centre Study in London 2009-2016



Hernandez, Bernard, Herrero-Vinas, Pau, Rawson, Timothy M ORCID: 0000-0002-2630-9722, Moore, Luke SP, Holmes, Alison H ORCID: 0000-0001-5554-5743 and Georgiou, Pantelis
(2021) Resistance Trend Estimation Using Regression Analysis to Enhance Antimicrobial Surveillance: A Multi-Centre Study in London 2009-2016. ANTIBIOTICS-BASEL, 10 (10). 1267-.

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Abstract

In the last years, there has been an increase of antimicrobial resistance rates around the world with the misuse and overuse of antimicrobials as one of the main leading drivers. In response to this threat, a variety of initiatives have arisen to promote the efficient use of antimicrobials. These initiatives rely on antimicrobial surveillance systems to promote appropriate prescription practices and are provided by national or global health care institutions with limited consideration of the variations within hospitals. As a consequence, physicians' adherence to these generic guidelines is still limited. To fill this gap, this work presents an automated approach to performing local antimicrobial surveillance from microbiology data. Moreover, in addition to the commonly reported resistance rates, this work estimates secular resistance trends through regression analysis to provide a single value that effectively communicates the resistance trend to a wider audience. The methods considered for trend estimation were ordinary least squares regression, weighted least squares regression with weights inversely proportional to the number of microbiology records available and autoregressive integrated moving average. Among these, weighted least squares regression was found to be the most robust against changes in the granularity of the time series and presented the best performance. To validate the results, three case studies have been thoroughly compared with the existing literature: (i) <i>Escherichia coli</i> in urine cultures; (ii) <i>Escherichia coli</i> in blood cultures; and (iii) <i>Staphylococcus aureus</i> in wound cultures. The benefits of providing local rather than general antimicrobial surveillance data of a higher quality is two fold. Firstly, it has the potential to stimulate engagement among physicians to strengthen their knowledge and awareness on antimicrobial resistance which might encourage prescribers to change their prescription habits more willingly. Moreover, it provides fundamental knowledge to the wide range of stakeholders to revise and potentially tailor existing guidelines to the specific needs of each hospital.

Item Type: Article
Uncontrolled Keywords: antimicrobial resistance, resistance rate, resistance trend, antimicrobial surveillance, regression analysis, time series analysis, escherichia coli, staphylococcus aureus
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 28 Oct 2022 15:03
Last Modified: 11 Nov 2023 15:16
DOI: 10.3390/antibiotics10101267
Open Access URL: https://doi.org/10.3390/antibiotics10101267
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3165854