Cargando…

A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis of an Expert Elicitation Study

To inform the UK antimicrobial resistance strategy, a risk assessment was undertaken of the likelihood, over a five-year time-frame, of the emergence and widespread dissemination of pan-drug-resistant (PDR) Gram-negative bacteria that would pose a major public health threat by compromising effective...

Descripción completa

Detalles Bibliográficos
Autores principales: Carter, Daniel, Charlett, André, Conti, Stefano, Robotham, Julie V., Johnson, Alan P., Livermore, David M., Fowler, Tom, Sharland, Mike, Hopkins, Susan, Woodford, Neil, Burgess, Philip, Dobra, Stephen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372989/
https://www.ncbi.nlm.nih.gov/pubmed/28272350
http://dx.doi.org/10.3390/antibiotics6010009
_version_ 1782518733551435776
author Carter, Daniel
Charlett, André
Conti, Stefano
Robotham, Julie V.
Johnson, Alan P.
Livermore, David M.
Fowler, Tom
Sharland, Mike
Hopkins, Susan
Woodford, Neil
Burgess, Philip
Dobra, Stephen
author_facet Carter, Daniel
Charlett, André
Conti, Stefano
Robotham, Julie V.
Johnson, Alan P.
Livermore, David M.
Fowler, Tom
Sharland, Mike
Hopkins, Susan
Woodford, Neil
Burgess, Philip
Dobra, Stephen
author_sort Carter, Daniel
collection PubMed
description To inform the UK antimicrobial resistance strategy, a risk assessment was undertaken of the likelihood, over a five-year time-frame, of the emergence and widespread dissemination of pan-drug-resistant (PDR) Gram-negative bacteria that would pose a major public health threat by compromising effective healthcare delivery. Subsequent impact over five- and 20-year time-frames was assessed in terms of morbidity and mortality attributable to PDR Gram-negative bacteraemia. A Bayesian approach, combining available data with expert prior opinion, was used to determine the probability of the emergence, persistence and spread of PDR bacteria. Overall probability was modelled using Monte Carlo simulation. Estimates of impact were also obtained using Bayesian methods. The estimated probability of widespread occurrence of PDR pathogens within five years was 0.2 (95% credibility interval (CrI): 0.07–0.37). Estimated annual numbers of PDR Gram-negative bacteraemias at five and 20 years were 6800 (95% CrI: 400–58,600) and 22,800 (95% CrI: 1500–160,000), respectively; corresponding estimates of excess deaths were 1900 (95% CrI: 0–23,000) and 6400 (95% CrI: 0–64,000). Over 20 years, cumulative estimates indicate 284,000 (95% CrI: 17,000–1,990,000) cases of PDR Gram-negative bacteraemia, leading to an estimated 79,000 (95% CrI: 0–821,000) deaths. This risk assessment reinforces the need for urgent national and international action to tackle antibiotic resistance.
format Online
Article
Text
id pubmed-5372989
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-53729892017-04-05 A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis of an Expert Elicitation Study Carter, Daniel Charlett, André Conti, Stefano Robotham, Julie V. Johnson, Alan P. Livermore, David M. Fowler, Tom Sharland, Mike Hopkins, Susan Woodford, Neil Burgess, Philip Dobra, Stephen Antibiotics (Basel) Article To inform the UK antimicrobial resistance strategy, a risk assessment was undertaken of the likelihood, over a five-year time-frame, of the emergence and widespread dissemination of pan-drug-resistant (PDR) Gram-negative bacteria that would pose a major public health threat by compromising effective healthcare delivery. Subsequent impact over five- and 20-year time-frames was assessed in terms of morbidity and mortality attributable to PDR Gram-negative bacteraemia. A Bayesian approach, combining available data with expert prior opinion, was used to determine the probability of the emergence, persistence and spread of PDR bacteria. Overall probability was modelled using Monte Carlo simulation. Estimates of impact were also obtained using Bayesian methods. The estimated probability of widespread occurrence of PDR pathogens within five years was 0.2 (95% credibility interval (CrI): 0.07–0.37). Estimated annual numbers of PDR Gram-negative bacteraemias at five and 20 years were 6800 (95% CrI: 400–58,600) and 22,800 (95% CrI: 1500–160,000), respectively; corresponding estimates of excess deaths were 1900 (95% CrI: 0–23,000) and 6400 (95% CrI: 0–64,000). Over 20 years, cumulative estimates indicate 284,000 (95% CrI: 17,000–1,990,000) cases of PDR Gram-negative bacteraemia, leading to an estimated 79,000 (95% CrI: 0–821,000) deaths. This risk assessment reinforces the need for urgent national and international action to tackle antibiotic resistance. MDPI 2017-03-07 /pmc/articles/PMC5372989/ /pubmed/28272350 http://dx.doi.org/10.3390/antibiotics6010009 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Carter, Daniel
Charlett, André
Conti, Stefano
Robotham, Julie V.
Johnson, Alan P.
Livermore, David M.
Fowler, Tom
Sharland, Mike
Hopkins, Susan
Woodford, Neil
Burgess, Philip
Dobra, Stephen
A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis of an Expert Elicitation Study
title A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis of an Expert Elicitation Study
title_full A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis of an Expert Elicitation Study
title_fullStr A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis of an Expert Elicitation Study
title_full_unstemmed A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis of an Expert Elicitation Study
title_short A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis of an Expert Elicitation Study
title_sort risk assessment of antibiotic pan-drug-resistance in the uk: bayesian analysis of an expert elicitation study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372989/
https://www.ncbi.nlm.nih.gov/pubmed/28272350
http://dx.doi.org/10.3390/antibiotics6010009
work_keys_str_mv AT carterdaniel ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT charlettandre ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT contistefano ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT robothamjuliev ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT johnsonalanp ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT livermoredavidm ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT fowlertom ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT sharlandmike ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT hopkinssusan ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT woodfordneil ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT burgessphilip ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT dobrastephen ariskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT carterdaniel riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT charlettandre riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT contistefano riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT robothamjuliev riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT johnsonalanp riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT livermoredavidm riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT fowlertom riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT sharlandmike riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT hopkinssusan riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT woodfordneil riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT burgessphilip riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy
AT dobrastephen riskassessmentofantibioticpandrugresistanceintheukbayesiananalysisofanexpertelicitationstudy