Utilising sigmoid models to predict the spread of antimicrobial resistance at the country level

Noga Fallach, Yaakov Dickstein, Erez Silberschein, John Turnidge, Elizabeth Temkin, Jonatan Almagor, Yehuda Carmeli

Research output: Contribution to journalArticlepeer-review


Background: The spread of antimicrobial resistance (AMR) is of worldwide concern. Public health policymakers and pharmaceutical companies pursuing antibiotic development require accurate predictions about the future spread of AMR. Aim: We aimed to identify and model temporal and geographical patterns of AMR spread and to predict future trends based on a slow, intermediate or rapid rise in resistance. Methods: We obtained data from five antibiotic resistance surveillance projects spanning the years 1997 to 2015. We aggregated the isolate-level or country-level data by country and year to produce country-bacterium-antibiotic class triads. We fitted both linear and sigmoid models to these triads and chose the one with the better fit. For triads that conformed to a sigmoid model, we classified AMR progression into one of three characterising paces: slow, intermediate or fast, based on the sigmoid slope. Within each pace category, average sigmoid models were calculated and validated. Results: We constructed a database with 51,670 country- year-bacterium-antibiotic observations, grouped into 7,440 country-bacterium-antibiotic triads. A total of 1,037 triads (14%) met the inclusion criteria. Of these, 326 (31.4%) followed a sigmoid (logistic) pattern over time. Among 107 triads for which both sigmoid and linear models could be fit, the sigmoid model was a better fit in 84%. The sigmoid model deviated from observed data by a median of 6.5%; the degree of deviation was related to the pace of spread. Conclusion: We present a novel method of describing and predicting the spread of antibiotic-resistant organisms.

Original languageEnglish
Article number1900387
Issue number23
StatePublished - 11 Jun 2020


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