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      Antimicrobial resistance in commensal opportunistic pathogens isolated from non-sterile sites can be an effective proxy for surveillance in bloodstream infections

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          Abstract

          Antimicrobial resistance (AMR) surveillance in bloodstream infections (BSIs) is challenging in low/middle-income countries (LMICs) given limited laboratory capacity. Other specimens are easier to collect and process and are more likely to be culture-positive. In 8102 E. coli BSIs, 322,087 E. coli urinary tract infections, 6952 S. aureus BSIs and 112,074 S. aureus non-sterile site cultures from Oxfordshire (1998–2018), and other (55,296 isolates) rarer commensal opportunistic pathogens, antibiotic resistance trends over time in blood were strongly associated with those in other specimens (maximum cross-correlation per drug 0.51–0.99). Resistance prevalence was congruent across drug-years for each species (276/312 (88%) species-drug-years with prevalence within ± 10% between blood/other isolates). Results were similar across multiple countries in high/middle/low income-settings in the independent ATLAS dataset (103,559 isolates, 2004–2017) and three further LMIC hospitals/programmes (6154 isolates, 2008–2019). AMR in commensal opportunistic pathogens cultured from BSIs is strongly associated with AMR in commensal opportunistic pathogens cultured from non-sterile sites over calendar time, suggesting the latter could be used as an effective proxy for AMR surveillance in BSIs.

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          Most cited references 21

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              A Concordance Correlation Coefficient to Evaluate Reproducibility

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                Author and article information

                Contributors
                karina-doris.vihta@eng.ox.ac.uk
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                3 December 2021
                3 December 2021
                2021
                : 11
                Affiliations
                [1 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Nuffield Department of Clinical Medicine, , University of Oxford, ; Oxford, UK
                [2 ]National Institute for Health Research Health Protection Research Unit, Oxford, UK
                [3 ]GRID grid.8991.9, ISNI 0000 0004 0425 469X, London School of Hygiene and Tropical Medicine, ; London, UK
                [4 ]GRID grid.410556.3, ISNI 0000 0001 0440 1440, Oxford University Hospitals NHS Foundation Trust, ; Oxford, UK
                [5 ]GRID grid.5335.0, ISNI 0000000121885934, University of Cambridge, ; Cambridge, UK
                [6 ]GRID grid.512492.9, ISNI 0000 0004 8340 240X, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, ; Vientiane, Laos
                [7 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, , University of Oxford, ; Oxford, UK
                [8 ]Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
                [9 ]GRID grid.10223.32, ISNI 0000 0004 1937 0490, Shoklo Malaria Research Unit, , Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, ; Mae Sot, Thailand
                [10 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Big Data Institute, , University of Oxford, ; Oxford, UK
                [11 ]GRID grid.10223.32, ISNI 0000 0004 1937 0490, Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, , Mahidol University, ; Bangkok, Thailand
                [12 ]GRID grid.8348.7, ISNI 0000 0001 2306 7492, Microbiology Research Level 7, , John Radcliffe Hospital, ; Headley Way, Oxford, OX3 9DU UK
                Article
                2755
                10.1038/s41598-021-02755-5
                8642463
                34862445
                967e54da-5e23-4f1f-a835-23fada7d550f
                © The Author(s) 2021

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                Funding
                Funded by: National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance
                Award ID: NIHR200915
                Funded by: Oxford NIHR Biomedical Research Centre
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                © The Author(s) 2021

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                epidemiology, antimicrobials

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