Development of a Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide the choice of the empiric antibiotic treatment for urinary tract infection in paediatric patients: a Bayesian approach
Abstract Background To evaluate the ability of Weighted-Incidence Syndromic Combination Antibiograms (WISCA) to inform the selection of empirical antibiotic regimens for suspected paediatric community-acquired urinary tract infections. Methods Data were collected from outpatients (< 15 years) acc...
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doaj-664807a24bd4414e8d6d1e16a568c4e92021-05-02T11:03:23ZengBMCAntimicrobial Resistance and Infection Control2047-29942021-05-0110111010.1186/s13756-021-00939-2Development of a Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide the choice of the empiric antibiotic treatment for urinary tract infection in paediatric patients: a Bayesian approachElisa Barbieri0Daniele Bottigliengo1Matteo Tellini2Chiara Minotti3Mara Marchiori4Paola Cavicchioli5Dario Gregori6Carlo Giaquinto7Liviana Da Dalt8Daniele Donà9Division of Paediatric Infectious Diseases- Department of Women’s and Children’s Health, University of PadovaDepartment of Cardiac, Thoracic and Vascular Sciences, Unit of Biostatistics, Epidemiology and Public Health, University of PadovaPaediatric Emergency Unit - Department of Women’s and Children’s Health, University of PadovaPaediatric Emergency Unit - Department of Women’s and Children’s Health, University of PadovaDepartment of Paediatrics, Ospedale Dell’AngeloDepartment of Paediatrics, Ospedale Dell’AngeloDepartment of Cardiac, Thoracic and Vascular Sciences, Unit of Biostatistics, Epidemiology and Public Health, University of PadovaDivision of Paediatric Infectious Diseases- Department of Women’s and Children’s Health, University of PadovaPaediatric Emergency Unit - Department of Women’s and Children’s Health, University of PadovaDivision of Paediatric Infectious Diseases- Department of Women’s and Children’s Health, University of PadovaAbstract Background To evaluate the ability of Weighted-Incidence Syndromic Combination Antibiograms (WISCA) to inform the selection of empirical antibiotic regimens for suspected paediatric community-acquired urinary tract infections. Methods Data were collected from outpatients (< 15 years) accessing the emergency rooms of Padua University-Hospital and Mestre Dell' Angelo-Hospital (Venice) between January 1st, 2016, and December 31st, 2018. WISCAs were developed by estimating the coverage of eight regimens using a Bayesian hierarchical model adjusted for age, sex, and previous antibiotic treatment or renal/urological comorbidities. Results 385 of 620 urine culture requests were included in the model analysis. The most frequently observed bacterium was E. coli (85% and 87%, Centre A and B). No centre effect on coverage estimates was found, and data were successfully pooled together. Coverage ranged from 77.8% (Co-trimoxazole) to 97.6% (Carbapenems). Complex cases and males had significantly lower odds of being covered by a regimen than non-complex cases and females (odds ratio (OR) 0.49 [95% HDI, 0.38–0.65], and OR: 0.73 [95% HDIs, 0.56–0.96] respectively). Children aged 3–5 years had lower odds of being covered by a regimen than other age groups, except for neonates. Conclusions The developed WISCAs provide highly informative estimates on coverage patterns overcoming the limitation of combination antibiograms and expanding the framework of previous Bayesian WISCA algorithm.https://doi.org/10.1186/s13756-021-00939-2Urinary tract infectionCombination antibiogramChildrenBayesian modelAntibiotic-resistanceAntimicrobial stewardship |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Elisa Barbieri Daniele Bottigliengo Matteo Tellini Chiara Minotti Mara Marchiori Paola Cavicchioli Dario Gregori Carlo Giaquinto Liviana Da Dalt Daniele Donà |
spellingShingle |
Elisa Barbieri Daniele Bottigliengo Matteo Tellini Chiara Minotti Mara Marchiori Paola Cavicchioli Dario Gregori Carlo Giaquinto Liviana Da Dalt Daniele Donà Development of a Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide the choice of the empiric antibiotic treatment for urinary tract infection in paediatric patients: a Bayesian approach Antimicrobial Resistance and Infection Control Urinary tract infection Combination antibiogram Children Bayesian model Antibiotic-resistance Antimicrobial stewardship |
author_facet |
Elisa Barbieri Daniele Bottigliengo Matteo Tellini Chiara Minotti Mara Marchiori Paola Cavicchioli Dario Gregori Carlo Giaquinto Liviana Da Dalt Daniele Donà |
author_sort |
Elisa Barbieri |
title |
Development of a Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide the choice of the empiric antibiotic treatment for urinary tract infection in paediatric patients: a Bayesian approach |
title_short |
Development of a Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide the choice of the empiric antibiotic treatment for urinary tract infection in paediatric patients: a Bayesian approach |
title_full |
Development of a Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide the choice of the empiric antibiotic treatment for urinary tract infection in paediatric patients: a Bayesian approach |
title_fullStr |
Development of a Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide the choice of the empiric antibiotic treatment for urinary tract infection in paediatric patients: a Bayesian approach |
title_full_unstemmed |
Development of a Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide the choice of the empiric antibiotic treatment for urinary tract infection in paediatric patients: a Bayesian approach |
title_sort |
development of a weighted-incidence syndromic combination antibiogram (wisca) to guide the choice of the empiric antibiotic treatment for urinary tract infection in paediatric patients: a bayesian approach |
publisher |
BMC |
series |
Antimicrobial Resistance and Infection Control |
issn |
2047-2994 |
publishDate |
2021-05-01 |
description |
Abstract Background To evaluate the ability of Weighted-Incidence Syndromic Combination Antibiograms (WISCA) to inform the selection of empirical antibiotic regimens for suspected paediatric community-acquired urinary tract infections. Methods Data were collected from outpatients (< 15 years) accessing the emergency rooms of Padua University-Hospital and Mestre Dell' Angelo-Hospital (Venice) between January 1st, 2016, and December 31st, 2018. WISCAs were developed by estimating the coverage of eight regimens using a Bayesian hierarchical model adjusted for age, sex, and previous antibiotic treatment or renal/urological comorbidities. Results 385 of 620 urine culture requests were included in the model analysis. The most frequently observed bacterium was E. coli (85% and 87%, Centre A and B). No centre effect on coverage estimates was found, and data were successfully pooled together. Coverage ranged from 77.8% (Co-trimoxazole) to 97.6% (Carbapenems). Complex cases and males had significantly lower odds of being covered by a regimen than non-complex cases and females (odds ratio (OR) 0.49 [95% HDI, 0.38–0.65], and OR: 0.73 [95% HDIs, 0.56–0.96] respectively). Children aged 3–5 years had lower odds of being covered by a regimen than other age groups, except for neonates. Conclusions The developed WISCAs provide highly informative estimates on coverage patterns overcoming the limitation of combination antibiograms and expanding the framework of previous Bayesian WISCA algorithm. |
topic |
Urinary tract infection Combination antibiogram Children Bayesian model Antibiotic-resistance Antimicrobial stewardship |
url |
https://doi.org/10.1186/s13756-021-00939-2 |
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