Contribution of Governance and Socioeconomic Factors to the P. aeruginosa MDR in Europe.

Julián Riaño-Moreno,Kernel Prieto,Jhoana P Romero-Leiton

doi:10.3390/antibiotics11020212

Abstract

This work aims to explain the behavior of the multi-drug resistance (MDR) percentage of Pseudomonas aeruginosa in Europe, through multivariate statistical analysis and machine learning validation, using data from the European Antimicrobial Resistance Surveillance System, the World Health Organization, and the World Bank. We ran a multidimensional data panel regression analysis and used machine learning techniques to validate a pooling panel data case. The results of our analysis showed that the most important variables explaining the MDR phenomena across European countries are governance variables, such as corruption control and the rule of law. The models proposed in this study showed the complexity of the antibiotic drugs resistance problem. The efforts controlling MDR P. aeruginosa, as a well-known Healthcare-Associated Infection (HCAI), should be focused on solving national governance problems that impact resource distribution, in addition to individual guidelines, such as promoting the appropriate use of antibiotics.

Highlights

Antimicrobial resistance (AMR) is an ever-growing concern in medicine and public health globally
In the United States (US), two of three deaths related to antibiotic-resistant pathogens are caused by multi-drug resistance (MDR) organisms commonly associated with healthcare [5]
In 2019, EARS-Net reported that 30.8% of the P. aeruginosa isolates were resistant to at least 1 of the 5 antimicrobial groups under regular surveillance across the European Union (EU) and European Economic Area (EEA) countries and reported a 12.1% population-weighted mean resistance in 2015–2019 to at least 3 antimicrobial groups [9] or MDR P. aeruginosa [10]

Summary

Introduction

Antimicrobial resistance (AMR) is an ever-growing concern in medicine and public health globally. Patients infected by AMR bacteria require extended hospital stays and costly and multiple treatments that result in an economic impact on both the patients and the healthcare system [1]. Several pathogens have started to develop AMR, that to first-line, inexpensive, broad-spectrum antibiotics, while the introduction of new drugs (e.g., fluoroquinolones) has been followed by the emergence and dissemination of resistant strains [2,3]. Single resistance is an important public health problem, MDR is a more critical and growing problem in the world. MDR tuberculosis caused 1.5 million deaths in 2018 (251,000 with HVI) [4]. In the United States (US), two of three deaths related to antibiotic-resistant pathogens are caused by MDR organisms commonly associated with healthcare [5]

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