TY - JOUR
T1 - Global forecast of antimicrobial resistance in invasive isolates of Escherichia coli and Klebsiella pneumoniae
AU - Alvarez-Uria, Gerardo
AU - Gandra, Sumanth
AU - Mandal, Siddhartha
AU - Laxminarayan, Ramanan
N1 - Funding Information:
The research leading to these results received support from the Bill & Melinda Gates Foundation for the ResistanceMap project (Investment ID OPP1112355 ) and from the Innovative Medicines Initiative Joint Undertaking under grant agreement number 115618 (Driving re-investment in R&D and responsible antibiotic use, DRIVE-AB, www.drive-ab.eu ) (for SG, RL), resources of which are composed of financial contributions from the European Union Seventh Framework Programme ( FP7/2007-2013 ) and European Federation of Pharmaceutical Industries and Associations ( EFPIA ) companies in kind contribution.
Funding Information:
The research leading to these results received support from the Bill & Melinda Gates Foundation for the ResistanceMap project (Investment ID OPP1112355) and from the Innovative Medicines Initiative Joint Undertaking under grant agreement number 115618 (Driving re-investment in R&D and responsible antibiotic use, DRIVE-AB, www.drive-ab.eu) (for SG, RL), resources of which are composed of financial contributions from the European Union Seventh Framework Programme (FP7/2007-2013) and European Federation of Pharmaceutical Industries and Associations (EFPIA) companies in kind contribution.
Publisher Copyright:
© 2018 The Author(s)
PY - 2018/3
Y1 - 2018/3
N2 - Objectives: To project future antimicrobial resistance (AMR) in Escherichia coli and Klebsiella pneumoniae. Methods: Mixed linear models were constructed from a sample of countries with AMR data in the ResistanceMap database. Inverse probability weighting methods were used to account for countries without AMR data. Results: The estimated prevalence of AMR in 2015 was 64.5% (95% confidence interval (CI) 42–87%) for third-generation cephalosporin-resistant (3GCR) Escherichia coli, 5.8% (95% CI 1.8–9.7%) for carbapenem-resistant (CR) E. coli, 66.9% (95% CI 47.1–86.8%) for 3GCR Klebsiella pneumoniae, and 23.4% (95% CI 7.4–39.4%) for CR K. pneumoniae. The projected AMR prevalence in 2030 was 77% (95% CI 55–99.1%) for 3GCR E. coli, 11.8% (95% CI 3.7–19.9%) for CR E. coli, 58.2% (95% CI 50.2–66.1%) for 3GCR K. pneumoniae, and 52.8% (95% CI 16.3–89.3%) for CR K. pneumoniae. Conclusions: The models suggest that third-generation cephalosporins and carbapenems could be ineffective against a sizeable proportion of infections by E. coli and K. pneumoniae in most parts of the world by 2030, supporting both the need to enhance stewardship efforts and to prioritize research and development of new antibiotics for resistant Enterobacteriaceae.
AB - Objectives: To project future antimicrobial resistance (AMR) in Escherichia coli and Klebsiella pneumoniae. Methods: Mixed linear models were constructed from a sample of countries with AMR data in the ResistanceMap database. Inverse probability weighting methods were used to account for countries without AMR data. Results: The estimated prevalence of AMR in 2015 was 64.5% (95% confidence interval (CI) 42–87%) for third-generation cephalosporin-resistant (3GCR) Escherichia coli, 5.8% (95% CI 1.8–9.7%) for carbapenem-resistant (CR) E. coli, 66.9% (95% CI 47.1–86.8%) for 3GCR Klebsiella pneumoniae, and 23.4% (95% CI 7.4–39.4%) for CR K. pneumoniae. The projected AMR prevalence in 2030 was 77% (95% CI 55–99.1%) for 3GCR E. coli, 11.8% (95% CI 3.7–19.9%) for CR E. coli, 58.2% (95% CI 50.2–66.1%) for 3GCR K. pneumoniae, and 52.8% (95% CI 16.3–89.3%) for CR K. pneumoniae. Conclusions: The models suggest that third-generation cephalosporins and carbapenems could be ineffective against a sizeable proportion of infections by E. coli and K. pneumoniae in most parts of the world by 2030, supporting both the need to enhance stewardship efforts and to prioritize research and development of new antibiotics for resistant Enterobacteriaceae.
KW - Drug resistance
KW - Enterobacteriaceae infections
KW - Forecasting
KW - Regression
UR - http://www.scopus.com/inward/record.url?scp=85041509566&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2018.01.011
DO - 10.1016/j.ijid.2018.01.011
M3 - Article
C2 - 29410253
AN - SCOPUS:85041509566
SN - 1201-9712
VL - 68
SP - 50
EP - 53
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -