Metapopulation ecology links antibiotic resistance, consumption and patient transfers in a network of hospital wards. - Archive ouverte HAL Access content directly
Preprints, Working Papers, ... Year : 2019

Metapopulation ecology links antibiotic resistance, consumption and patient transfers in a network of hospital wards.

Julie Teresa Shapiro
  • Function : Author
Gilles Leboucher
  • Function : Author
  • PersonId : 912969
Anne-Florence Myard-Dury
  • Function : Author
Pascale Girardo
  • Function : Author
Anatole Luzatti
  • Function : Author
Mélissa Mary
  • Function : Author
Jean-François Sauzon
  • Function : Author
Olivier Dauwalder
  • Function : Author
Frédéric Laurent
  • Function : Author
Gérard Lina
Christian Chidiac
  • Function : Author
  • PersonId : 1062515
Sandrine Couray-Targe
  • Function : Author
François Vandenesch
Jean-Pierre Flandrois
Jean-Philippe Rasigade
  • Function : Author
  • PersonId : 1060379

Abstract

Antimicrobial resistance (AMR) is a global threat. A better understanding of how antibiotic use and between-ward patient transfers (or connectivity) impact hospital AMR can help optimize antibiotic stewardship and infection control strategies. Here, we used metapopulation ecology to explain variations in infection incidences of 17 ESKAPE pathogen variants in a network of 357 hospital wards. Multivariate models identified the strongest influence of ward-level antibiotic use on more resistant variants, and of connectivity on nosocomial species and carbapenem-resistant variants. Pairwise associations between infection incidence and the consumption of specific antibiotics were significantly stronger when such associations represented a priori AMR selection, suggesting that AMR evolves within the network. Piperacillin-tazobactam consumption was the strongest predictor of the cumulative incidence of infections resistant to empirical sepsis therapy. Our data establish that both antibiotic use and connectivity measurably influence hospital AMR and provide a ranking of key antibiotics by their impact on AMR.
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hal-02402135 , version 1 (10-12-2019)

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Julie Teresa Shapiro, Gilles Leboucher, Anne-Florence Myard-Dury, Pascale Girardo, Anatole Luzatti, et al.. Metapopulation ecology links antibiotic resistance, consumption and patient transfers in a network of hospital wards.. 2019. ⟨hal-02402135⟩
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