Bayesian modeling of the impact of antibiotic resistance on the efficiency of MRSA decolonization

Author:

Ojala FanniORCID,Sater Mohamad R. Abdul,Miller Loren G.,McKinnell James A.,Hayden Mary K.,Huang Susan S.,Grad Yonatan H.,Marttinen Pekka

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of morbidity and mortality. Colonization by MRSA increases the risk of infection and transmission, underscoring the importance of decolonization efforts. However, success of these decolonization protocols varies, raising the possibility that some MRSA strains may be more persistent than others. Here, we studied how the persistence of MRSA colonization correlates with genomic presence of antibiotic resistance genes. Our analysis using a Bayesian mixed effects survival model found that genetic determinants of high-level resistance to mupirocin was strongly associated with failure of the decolonization protocol. However, we did not see a similar effect with genetic resistance to chlorhexidine or other antibiotics. Including strain-specific random effects improved the predictive performance, indicating that some strain characteristics other than resistance also contributed to persistence. Study subject-specific random effects did not improve the model. Our results highlight the need to consider the properties of the colonizing MRSA strain when deciding which treatments to include in the decolonization protocol.

Funder

Research Council of Finland

EU H2020

EU NextGenerationEU

Doris Duke Charitable Foundation

AHRQ Healthcare-Associated Infections Program

Institute for Clinical and Translational Science, University of California, Irvine

Publisher

Public Library of Science (PLoS)

Subject

Computational Theory and Mathematics,Cellular and Molecular Neuroscience,Genetics,Molecular Biology,Ecology,Modeling and Simulation,Ecology, Evolution, Behavior and Systematics

Reference32 articles.

1. Staphylococcus aureus infections: Epidemiology, pathophysiology, clinical manifestations, and management;SYC Tong;Clinical Microbiology Reviews,2015

2. Antimicrobial-Resistant Pathogens Associated with Healthcare-Associated Infections: Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009–2010;DM Sievert;Source: Infection Control and Hospital Epidemiology,2013

3. Improving Methicillin-Resistant Staphylococcus aureus Surveillance and Reporting in Intensive Care Units;SS Huang;The Journal of Infectious Diseases,2007

4. Nasal Carriage as a Source of Staphylococcus aureus Bacteremia;C von Eiff;New England Journal of Medicine,2001

5. Methicillin-resistant staphylococcus aureus infection and hospitalization in high-risk patients in the year following detection;SS Huang;PLoS ONE,2011

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3