Evaluation of ESBL resistance dynamics in Escherichia coli isolates by mathematical modeling

Abstract

Abstract Antibiotic resistance is becoming one of the threats to global health. This crisis has been attributed to the over-the-counter and overuse of antibiotics leading bacteria to gain the ability to resist and survive even in the presence of antimicrobial agents. Escherichia coli (E. coli) is one of the major gram-negative bacteria that are the representative indicators of antibiotic resistance. One of the mechanisms of gaining antibiotic resistance is the ability of E. coli to gain the production of extended-spectrum beta-lactamases (ESBL). In this study, Near East University Hospital data from 2016 to 2019 were used to study the dynamics of ESBL-producing ( ESBL + {\text{ESBL}}^{+} ) and non-ESBL-producing ( ESBL − {\text{ESBL}}^{-} ) E. coli infections by using a mathematical model. In our study, the aim was to evaluate the distribution of infections caused by resistant E. coli strains in later years and to increase the success of treatment in patients infected with E. coli by reducing the problem of antibiotic resistance. By using the mathematical model and data of the patients, basic reproduction number (R 0) values were calculated to study epidemiologic dynamics of the disease. The R 0 E − {R}_{0}^{{E}^{-}} and R 0 E + {R}_{0}^{{E}^{+}} values for ESBL − {\text{ESBL}}^{-} and  ESBL +   {\text{ ESBL}}^{+}\text{ } E. coli infections were calculated, respectively. According to the model and the data used within the study, it was calculated that R 0 E − {R}_{0}^{{E}^{-}} to be 1,266,403 and R 0 E + {R}_{0}^{{E}^{+}} to be 2,096,747. Since the values for R 0 E − {R}_{0}^{{E}^{-}} and R 0 E + {R}_{0}^{{E}^{+}} were equal or greater than 1, this suggests that currently the ESBL − \hspace{.25em}{\text{ESBL}}^{-} and  ESBL +   {\text{ ESBL}}^{+}\text{ } E. coli infections are in epidemic character for Cyprus. Furthermore, when simulation analyses were carried out for the model, it was predicted that in 2042 the ESBL − {\text{ESBL}}^{-} and  ESBL + {\text{ ESBL}}^{+} E. coli infection trends will equalize. After 2042, the ESBL −   {\text{ESBL}}^{-}\text{ } E. coli infections will indicate a descending pattern whereas  ESBL +   {\text{ ESBL}}^{+}\text{ } E. coli infection will increase constantly.