TY - JOUR
T1 - Quantifying antibiotic impact on within-patient dynamics of extended-spectrum beta-lactamase resistance
AU - Niehus, Rene
AU - van Kleef, Esther
AU - Mo, Yin
AU - Turlej-Rogacka, Agata
AU - Lammens, Christine
AU - Carmeli, Yehuda
AU - Goossens, Herman
AU - Tacconelli, Evelina
AU - Carevic, Biljana
AU - Preotescu, Liliana
AU - Malhotra-Kumar, Surbhi
AU - Cooper, Ben S.
N1 - Publisher Copyright:
© Niehus et al.
PY - 2020/5
Y1 - 2020/5
N2 - Antibiotic-induced perturbation of the human gut flora is expected to play an important role in mediating the relationship between antibiotic use and the population prevalence of antibiotic resistance in bacteria, but little is known about how antibiotics affect within-host resistance dynamics. Here we develop a data-driven model of the within-host dynamics of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae. We use blaCTX-M (the most widespread ESBL gene family) and 16S rRNA (a proxy for bacterial load) abundance data from 833 rectal swabs from 133 ESBL-positive patients followed up in a prospective cohort study in three European hospitals. We find that cefuroxime and ceftriaxone are associated with increased blaCTX-M abundance during treatment (21% and 10% daily increase, respectively), while treatment with meropenem, piperacillin-tazobactam, and oral ciprofloxacin is associated with decreased blaCTX-M (8% daily decrease for all). The model predicts that typical antibiotic exposures can have substantial long-term effects on blaCTX-M carriage duration.
AB - Antibiotic-induced perturbation of the human gut flora is expected to play an important role in mediating the relationship between antibiotic use and the population prevalence of antibiotic resistance in bacteria, but little is known about how antibiotics affect within-host resistance dynamics. Here we develop a data-driven model of the within-host dynamics of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae. We use blaCTX-M (the most widespread ESBL gene family) and 16S rRNA (a proxy for bacterial load) abundance data from 833 rectal swabs from 133 ESBL-positive patients followed up in a prospective cohort study in three European hospitals. We find that cefuroxime and ceftriaxone are associated with increased blaCTX-M abundance during treatment (21% and 10% daily increase, respectively), while treatment with meropenem, piperacillin-tazobactam, and oral ciprofloxacin is associated with decreased blaCTX-M (8% daily decrease for all). The model predicts that typical antibiotic exposures can have substantial long-term effects on blaCTX-M carriage duration.
UR - https://www.scopus.com/pages/publications/85084720804
U2 - 10.7554/eLife.49206
DO - 10.7554/eLife.49206
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C2 - 32379042
AN - SCOPUS:85084720804
SN - 2050-084X
VL - 9
SP - 1
EP - 20
JO - eLife
JF - eLife
M1 - e49206
ER -