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Open Access 01-12-2022 | Public Health | Research

The impact of public health interventions on the future prevalence of ESBL-producing Klebsiella pneumoniae: a population based mathematical modelling study

Authors: Luisa Salazar-Vizcaya, Andrew Atkinson, Andreas Kronenberg, Catherine Plüss-Suard, Roger D. Kouyos, Viacheslav Kachalov, Nicolas Troillet, Jonas Marschall, Rami Sommerstein

Published in: BMC Infectious Diseases | Issue 1/2022

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Abstract

Background

Future prevalence of colonization with extended-spectrum betalactamase (ESBL-) producing K. pneumoniae in humans and the potential of public health interventions against the spread of these resistant bacteria remain uncertain.

Methods

Based on antimicrobial consumption and susceptibility data recorded during > 13 years in a Swiss region, we developed a mathematical model to assess the comparative effect of different interventions on the prevalence of colonization.

Results

Simulated prevalence stabilized in the near future when rates of antimicrobial consumption and in-hospital transmission were assumed to remain stable (2025 prevalence: 6.8% (95CI%:5.4–8.8%) in hospitals, 3.5% (2.5–5.0%) in the community versus 6.1% (5.0–7.5%) and 3.2% (2.3–4.2%) in 2019, respectively). When overall antimicrobial consumption was set to decrease by 50%, 2025 prevalence declined by 75% in hospitals and by 64% in the community. A 50% decline in in-hospital transmission rate led to a reduction in 2025 prevalence of 31% in hospitals and no reduction in the community. The best model fit estimated that 49% (6–100%) of observed colonizations could be attributable to sources other than human-to-human transmission within the geographical setting.

Conclusions

Projections suggests that overall antimicrobial consumption will be, by far, the most powerful driver of prevalence and that a large fraction of colonizations could be attributed to non-local transmissions.
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Metadata
Title
The impact of public health interventions on the future prevalence of ESBL-producing Klebsiella pneumoniae: a population based mathematical modelling study
Authors
Luisa Salazar-Vizcaya
Andrew Atkinson
Andreas Kronenberg
Catherine Plüss-Suard
Roger D. Kouyos
Viacheslav Kachalov
Nicolas Troillet
Jonas Marschall
Rami Sommerstein
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07441-z

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