scholarly journals A nonlinear time-series analysis approach to identify thresholds in associations between population antibiotic use and rates of resistance

2019 ◽  
Vol 4 (7) ◽  
pp. 1160-1172 ◽  
Author(s):  
José-María López-Lozano ◽  
◽  
Timothy Lawes ◽  
César Nebot ◽  
Arielle Beyaert ◽  
...  
2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S844-S845
Author(s):  
Marianna Meschiari ◽  
José María Lòpez-Lozano ◽  
Arielle Beyaert ◽  
Cesar Nebot ◽  
Gabriella Orlando ◽  
...  

Abstract Background To estimate the impact of antimicrobials stewardship in the temporary evolution of the Density Incidence of Pseudomonas aeruginosa resistant to carbapenems (DI_PaCRE). Methods In Modena Policlinico, a tertiary care hospital, from September 2014, universal rectal screening and antibiotic stewardship (ABS) focusing on carbapenem sparing strategy were introduced. We used the statistical approach already described (A nonlinear time-series analysis approach to identify thresholds in associations between population antibiotic use and rates of resistance. López-Lozano JM, et al. Nat Microbiol. 2019 Apr 8. doi: 10.1038/s41564-019–0410-0) in order to adjust a non-linear model (Multivariate Adaptive Regression Splines) looking for the identification and estimation of thresholds in the influence of the use of Carbapenems on the DI_PaCRE. Results We identified a threshold at 5.65 DDD/100 bed-days of Carbapenems (CarbUse). Indeed, above this threshold, for every increase of one DDD/100 bed-days, the DI_PaCRE increased by 0.15 new cases by 1000 bed-days. On the basis of our analyses, considering a typical course of 7 days of treatment, an average CarbUse of 6.5 DDD/100 bed-days in 2012 and 2013, for an average of 15000 monthly bed-days, means around 139 treated patients. In order to avoid the emergence of resistance, the threshold was equivalent to a maximum number of 121 patients to be treated. Below this threshold, i.e in 2018, CarbUse including 66 patients treated did not select antimicrobial resistance. Conclusion PaCRE could be controlled by reducing the use of carbapenems below minimum thresholds of 6.5 DDD/100 bed-days. In order to avoid the onset of resistance to carbapenems in Pseudomonas aeruginosa, less than 121 patients per month should receive this class of drug. This finding could provide innovative approach to guide antimicrobial stewardship strategy focused on limit the spread of PaCRE in hospital populations. Disclosures All authors: No reported disclosures.


Author(s):  
Ray Huffaker ◽  
Marco Bittelli ◽  
Rodolfo Rosa

In the process of data analysis, the investigator is often facing highly-volatile and random-appearing observed data. A vast body of literature shows that the assumption of underlying stochastic processes was not necessarily representing the nature of the processes under investigation and, when other tools were used, deterministic features emerged. Non Linear Time Series Analysis (NLTS) allows researchers to test whether observed volatility conceals systematic non linear behavior, and to rigorously characterize governing dynamics. Behavioral patterns detected by non linear time series analysis, along with scientific principles and other expert information, guide the specification of mechanistic models that serve to explain real-world behavior rather than merely reproducing it. Often there is a misconception regarding the complexity of the level of mathematics needed to understand and utilize the tools of NLTS (for instance Chaos theory). However, mathematics used in NLTS is much simpler than many other subjects of science, such as mathematical topology, relativity or particle physics. For this reason, the tools of NLTS have been confined and utilized mostly in the fields of mathematics and physics. However, many natural phenomena investigated I many fields have been revealing deterministic non linear structures. In this book we aim at presenting the theory and the empirical of NLTS to a broader audience, to make this very powerful area of science available to many scientific areas. This book targets students and professionals in physics, engineering, biology, agriculture, economy and social sciences as a textbook in Nonlinear Time Series Analysis (NLTS) using the R computer language.


2012 ◽  
Vol 22 (03) ◽  
pp. 1250044
Author(s):  
LANCE ONG-SIONG CO TING KEH ◽  
ANA MARIA AQUINO CHUPUNGCO ◽  
JOSE PERICO ESGUERRA

Three methods of nonlinear time series analysis, Lempel–Ziv complexity, prediction error and covariance complexity were employed to distinguish between the electroencephalograms (EEGs) of normal children, children with mild autism, and children with severe autism. Five EEG tracings per cluster of children aged three to seven medically diagnosed with mild, severe and no autism were used in the analysis. A general trend seen was that the EEGs of children with mild autism were significantly different from those with severe or no autism. No significant difference was observed between normal children and children with severe autism. Among the three methods used, the method that was best able to distinguish between EEG tracings of children with mild and severe autism was found to be the prediction error, with a t-Test confidence level of above 98%.


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