Cited by 18Antibiotic Use and ResistanceAntibiotic Resistance in BacteriaAntimicrobial Resistance in Staphylococcus

The DOI matches its Crossref record; 44 of the 45 references it cites were found in a registry or an index.

Does Antibiotic Resistance Evolve in Hospitals?

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Seigal, Anna, Mira, Portia, Sturmfels, Bernd, Barlow, Miriam·2017·Bulletin of Mathematical Biology

Abstract

Nosocomial outbreaks of bacteria are well documented. Based on these incidents, and the heavy usage of antibiotics in hospitals, it has been assumed that antibiotic resistance evolves in hospital environments. To test this assumption, we studied resistance phenotypes of bacteria collected from patient isolates at a community hospital over a 2.5-year period. A graphical model analysis shows no association between resistance and patient information other than time of arrival. This allows us to focus on time-course data. We introduce a hospital transmission model, based on negative binomial delay. Our main contribution is a statistical hypothesis test called the Nosocomial Evolution of Resistance Detector (NERD). It calculates the significance of resistance trends occurring in a hospital. It can inform hospital staff about the effects of various practices and interventions, can help detect clonal outbreaks, and is available as an R package. We applied the NERD method to each of the 16 antibiotics in the study via 16 hypothesis tests. For 13 of the antibiotics, we found that the hospital environment had no significant effect on the evolution of resistance; the hospital is merely a piece of the larger picture. The p-values obtained for the other three antibiotics (cefepime, ceftazidime, and gentamicin) indicate that particular care should be taken in hospital practices with these antibiotics. One of the three, ceftazidime, was significant after accounting for multiple hypotheses, indicating a trend of decreased resistance for this drug.

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  1. Lauritzen SL (2004) Graphical models. Oxford University, Oxford

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Metadata

Authors
Seigal, A., Mira, P., Sturmfels, B., & Barlow, M.
Affiliations
  • University of California, Berkeley (US)
  • University of California, Merced (US)
Corresponding author
Seigal, Anna
Venue
Bulletin of Mathematical Biology
Published
2016-12-06
Volume
79
Issue
1
Pages
191-208
ISSN
  • 0092-8240 (ISSN-L)
  • 1522-9602
OpenAlex
W2385824832
Cited by
18
References
45
Citations by year
2023: 1 · 2022: 1 · 2020: 4 · 2019: 12
FWCI
2.79
Type
journal article
Language
en
Open access
Locations
  • Bulletin of Mathematical Biology (publishedVersion)
  • PubMed (publishedVersion)
  • arXiv (Cornell University) (submittedVersion)
  • arXiv (Cornell University)
Funders
  • National Science Foundation (DMS-1419018)
  • Center for Information Technology Research in the Interest of Society (2015-324)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
  • Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
  • Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
Keywords
antibiotic resistance, nosocomial infections, nosocomial transmission, resistance evolution, patient isolates, clonal outbreak, ceftazidime, cefepime, gentamicin, resistance trends, community hospitals
MeSH terms
Bacterial Infections, Cross Infection, Disease Outbreaks, Humans, Models, Biological, Evolution, Molecular, Drug Resistance, Bacterial, Mathematical Concepts

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Seigal, A., Mira, P., Sturmfels, B., & Barlow, M. (2017). Does Antibiotic Resistance Evolve in Hospitals? Bulletin of Mathematical Biology. https://doi.org/10.1007/s11538-016-0232-7