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  1. Article ; Online: Antimicrobial resistance at the G7.

    Glover, Rebecca E / Knight, Gwenan M / Chandler, Clare I R

    BMJ (Clinical research ed.)

    2021  Volume 373, Page(s) n1417

    MeSH term(s) Drug Resistance, Microbial ; Global Health ; Humans ; International Cooperation ; United Kingdom
    Language English
    Publishing date 2021-06-03
    Publishing country England
    Document type Editorial
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.n1417
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: AHHME: A model for estimating the holistic cost-effectiveness of antimicrobial resistance interventions in food animal production.

    Emes, Eve T / Waage, Jeff / Knight, Gwenan M / Naylor, Nichola R

    One health (Amsterdam, Netherlands)

    2023  Volume 17, Page(s) 100629

    Abstract: Antimicrobial resistance (AMR) is considered a global priority for human health, and reducing antimicrobial use in food animals has been suggested as a key area for interventions aiming to reduce resistant infections in humans. In addition to the effect ... ...

    Abstract Antimicrobial resistance (AMR) is considered a global priority for human health, and reducing antimicrobial use in food animals has been suggested as a key area for interventions aiming to reduce resistant infections in humans. In addition to the effect on human health, such interventions may have effects across food animal productivity, healthcare sector costs, and the broader macroeconomy, but these effects are rarely captured in the AMR health economic literature. Without being able to estimate these effects, it is difficult to understand the true cost-effectiveness of antimicrobial stewardship interventions in food animal production, or to correctly design and prioritise such interventions. We explore and demonstrate the potential use of a novel compartment-based mathematical model to estimate the holistic cost-effectiveness of AMR-related interventions in food animal production from a One Health perspective. The Agriculture Human Health Micro-Economic model (AHHME) uses Markov state transition models to model the movement of humans and food animals between health states. It assigns values to these health states utilising empiric approaches, from the perspectives of human health, food animal productivity, labour productivity and healthcare sector costs. Providing AHHME open-source code and interactive online modelling tools allow for capacity building in AMR intervention modelling. This model represents a useful framework for capturing the cost-effectiveness of AMR-related interventions in food animal production in a more holistic way: it can allow us to capture the often-overlooked benefits of such interventions in like terms while considering distributional concerns. It also demonstrates that methodological assumptions such as willingness-to-pay thresholds and discount rates can be just as important to health decision models as epidemiological parameters, and allows these assumptions to be altered. We provide example outputs, and encourage researchers and policymakers to use and adapt our code to explore, design, and prioritise AMR-related interventions in their own country contexts.
    Language English
    Publishing date 2023-09-16
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2834831-X
    ISSN 2352-7714
    ISSN 2352-7714
    DOI 10.1016/j.onehlt.2023.100629
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Quantifying patient- and hospital-level antimicrobial resistance dynamics in

    Leclerc, Quentin / Clements, Alastair / Dunn, Helen / Hatcher, James / Lindsay, Jodi A / Grandjean, Louis / Knight, Gwenan M

    medRxiv : the preprint server for health sciences

    2023  

    Abstract: Antimicrobial resistance (AMR) to all antibiotic classes has been found in the ... ...

    Abstract Antimicrobial resistance (AMR) to all antibiotic classes has been found in the pathogen
    Language English
    Publishing date 2023-02-16
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2023.02.15.23285946
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Modelling the synergistic effect of bacteriophage and antibiotics on bacteria: Killers and drivers of resistance evolution.

    Leclerc, Quentin J / Lindsay, Jodi A / Knight, Gwenan M

    PLoS computational biology

    2022  Volume 18, Issue 11, Page(s) e1010746

    Abstract: Bacteriophage (phage) are bacterial predators that can also spread antimicrobial resistance (AMR) genes between bacteria by generalised transduction. Phage are often present alongside antibiotics in the environment, yet evidence of their joint killing ... ...

    Abstract Bacteriophage (phage) are bacterial predators that can also spread antimicrobial resistance (AMR) genes between bacteria by generalised transduction. Phage are often present alongside antibiotics in the environment, yet evidence of their joint killing effect on bacteria is conflicted, and the dynamics of transduction in such systems are unknown. Here, we combine in vitro data and mathematical modelling to identify conditions where phage and antibiotics act in synergy to remove bacteria or drive AMR evolution. We adapt a published model of phage-bacteria dynamics, including transduction, to add the pharmacodynamics of erythromycin and tetracycline, parameterised from new in vitro data. We simulate a system where two strains of Staphylococcus aureus are present at stationary phase, each carrying either an erythromycin or tetracycline resistance gene, and where multidrug-resistant bacteria can be generated by transduction only. We determine rates of bacterial clearance and multidrug-resistant bacteria appearance, when either or both antibiotics and phage are present at varying timings and concentrations. Although phage and antibiotics act in synergy to kill bacteria, by reducing bacterial growth antibiotics reduce phage production. A low concentration of phage introduced shortly after antibiotics fails to replicate and exert a strong killing pressure on bacteria, instead generating multidrug-resistant bacteria by transduction which are then selected for by the antibiotics. Multidrug-resistant bacteria numbers were highest when antibiotics and phage were introduced simultaneously. The interaction between phage and antibiotics leads to a trade-off between a slower clearing rate of bacteria (if antibiotics are added before phage), and a higher risk of multidrug-resistance evolution (if phage are added before antibiotics), exacerbated by low concentrations of phage or antibiotics. Our results form hypotheses to guide future experimental and clinical work on the impact of phage on AMR evolution, notably for studies of phage therapy which should investigate varying timings and concentrations of phage and antibiotics.
    Language English
    Publishing date 2022-11-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2193340-6
    ISSN 1553-7358 ; 1553-734X
    ISSN (online) 1553-7358
    ISSN 1553-734X
    DOI 10.1371/journal.pcbi.1010746
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Correction for Leclerc et al., "Growth-Dependent Predation and Generalized Transduction of Antimicrobial Resistance by Bacteriophage".

    Leclerc, Quentin J / Wildfire, Jacob / Gupta, Arya / Lindsay, Jodi A / Knight, Gwenan M

    mSystems

    2022  Volume 8, Issue 1, Page(s) e0097422

    Language English
    Publishing date 2022-12-12
    Publishing country United States
    Document type Journal Article ; Published Erratum
    ISSN 2379-5077
    ISSN (online) 2379-5077
    DOI 10.1128/msystems.00974-22
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Quantifying patient- and hospital-level antimicrobial resistance dynamics in

    Leclerc, Quentin / Clements, Alastair / Dunn, Helen / Hatcher, James / Lindsay, Jodi A / Grandjean, Louis / Knight, Gwenan M

    Journal of medical microbiology

    2023  Volume 72, Issue 7

    Abstract: Introduction. ...

    Abstract Introduction.
    MeSH term(s) Child ; Humans ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Staphylococcus aureus/genetics ; Methicillin ; Routinely Collected Health Data ; Drug Resistance, Bacterial ; Staphylococcal Infections/epidemiology ; Hospitals, Pediatric
    Chemical Substances Anti-Bacterial Agents ; Methicillin (Q91FH1328A)
    Language English
    Publishing date 2023-07-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 218356-0
    ISSN 1473-5644 ; 0022-2615
    ISSN (online) 1473-5644
    ISSN 0022-2615
    DOI 10.1099/jmm.0.001724
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Mathematical models of drug-resistant tuberculosis lack bacterial heterogeneity: A systematic review.

    Fuller, Naomi M / McQuaid, Christopher F / Harker, Martin J / Weerasuriya, Chathika K / McHugh, Timothy D / Knight, Gwenan M

    PLoS pathogens

    2024  Volume 20, Issue 4, Page(s) e1011574

    Abstract: ... of mathematical models of DR-mycobacteria, including M. tuberculosis. The second objective was to analyse methods ... transmission models of non-treatment intervention impact in M. tuberculosis (n = 58). Studies were set ...

    Abstract Drug-resistant tuberculosis (DR-TB) threatens progress in the control of TB. Mathematical models are increasingly being used to guide public health decisions on managing both antimicrobial resistance (AMR) and TB. It is important to consider bacterial heterogeneity in models as it can have consequences for predictions of resistance prevalence, which may affect decision-making. We conducted a systematic review of published mathematical models to determine the modelling landscape and to explore methods for including bacterial heterogeneity. Our first objective was to identify and analyse the general characteristics of mathematical models of DR-mycobacteria, including M. tuberculosis. The second objective was to analyse methods of including bacterial heterogeneity in these models. We had different definitions of heterogeneity depending on the model level. For between-host models of mycobacterium, heterogeneity was defined as any model where bacteria of the same resistance level were further differentiated. For bacterial population models, heterogeneity was defined as having multiple distinct resistant populations. The search was conducted following PRISMA guidelines in five databases, with studies included if they were mechanistic or simulation models of DR-mycobacteria. We identified 195 studies modelling DR-mycobacteria, with most being dynamic transmission models of non-treatment intervention impact in M. tuberculosis (n = 58). Studies were set in a limited number of specific countries, and 44% of models (n = 85) included only a single level of "multidrug-resistance (MDR)". Only 23 models (8 between-host) included any bacterial heterogeneity. Most of these also captured multiple antibiotic-resistant classes (n = 17), but six models included heterogeneity in bacterial populations resistant to a single antibiotic. Heterogeneity was usually represented by different fitness values for bacteria resistant to the same antibiotic (61%, n = 14). A large and growing body of mathematical models of DR-mycobacterium is being used to explore intervention impact to support policy as well as theoretical explorations of resistance dynamics. However, the majority lack bacterial heterogeneity, suggesting that important evolutionary effects may be missed.
    MeSH term(s) Humans ; Mycobacterium tuberculosis/drug effects ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Multidrug-Resistant/microbiology ; Models, Theoretical ; Antitubercular Agents/pharmacology ; Antitubercular Agents/therapeutic use
    Chemical Substances Antitubercular Agents
    Language English
    Publishing date 2024-04-10
    Publishing country United States
    Document type Journal Article ; Systematic Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2205412-1
    ISSN 1553-7374 ; 1553-7374
    ISSN (online) 1553-7374
    ISSN 1553-7374
    DOI 10.1371/journal.ppat.1011574
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Guiding pragmatic treatment choices for rifampicin-resistant tuberculosis in the absence of second-line drug susceptibility testing.

    Achar, Jay / Seddon, James A / Knight, Gwenan M / Dodd, Peter J / Esmail, Hanif / Hughes, Jennifer / McQuaid, C Finn

    The European respiratory journal

    2023  Volume 62, Issue 5

    MeSH term(s) Humans ; Rifampin/therapeutic use ; Mycobacterium tuberculosis ; Microbial Sensitivity Tests ; Tuberculosis, Multidrug-Resistant/drug therapy ; Isoniazid/therapeutic use ; Antitubercular Agents/therapeutic use ; Antitubercular Agents/pharmacology ; Drug Resistance, Bacterial
    Chemical Substances Rifampin (VJT6J7R4TR) ; Isoniazid (V83O1VOZ8L) ; Antitubercular Agents
    Language English
    Publishing date 2023-11-29
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 639359-7
    ISSN 1399-3003 ; 0903-1936
    ISSN (online) 1399-3003
    ISSN 0903-1936
    DOI 10.1183/13993003.00969-2023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: AHHME

    Eve T. Emes / Jeff Waage / Gwenan M. Knight / Nichola R. Naylor

    One Health, Vol 17, Iss , Pp 100629- (2023)

    A model for estimating the holistic cost-effectiveness of antimicrobial resistance interventions in food animal production

    2023  

    Abstract: Antimicrobial resistance (AMR) is considered a global priority for human health, and reducing antimicrobial use in food animals has been suggested as a key area for interventions aiming to reduce resistant infections in humans. In addition to the effect ... ...

    Abstract Antimicrobial resistance (AMR) is considered a global priority for human health, and reducing antimicrobial use in food animals has been suggested as a key area for interventions aiming to reduce resistant infections in humans. In addition to the effect on human health, such interventions may have effects across food animal productivity, healthcare sector costs, and the broader macroeconomy, but these effects are rarely captured in the AMR health economic literature. Without being able to estimate these effects, it is difficult to understand the true cost-effectiveness of antimicrobial stewardship interventions in food animal production, or to correctly design and prioritise such interventions.We explore and demonstrate the potential use of a novel compartment-based mathematical model to estimate the holistic cost-effectiveness of AMR-related interventions in food animal production from a One Health perspective. The Agriculture Human Health Micro-Economic model (AHHME) uses Markov state transition models to model the movement of humans and food animals between health states. It assigns values to these health states utilising empiric approaches, from the perspectives of human health, food animal productivity, labour productivity and healthcare sector costs. Providing AHHME open-source code and interactive online modelling tools allow for capacity building in AMR intervention modelling.This model represents a useful framework for capturing the cost-effectiveness of AMR-related interventions in food animal production in a more holistic way: it can allow us to capture the often-overlooked benefits of such interventions in like terms while considering distributional concerns. It also demonstrates that methodological assumptions such as willingness-to-pay thresholds and discount rates can be just as important to health decision models as epidemiological parameters, and allows these assumptions to be altered. We provide example outputs, and encourage researchers and policymakers to use and adapt our code to explore, ...
    Keywords Livestock ; One health ; Antimicrobial resistance ; Intervention evaluation ; Health economics ; Medicine (General) ; R5-920
    Subject code 360
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Dehydration Tolerance in Epidemic versus Nonepidemic MRSA Demonstrated by Isothermal Microcalorimetry.

    Baede, Valérie O / Tavakol, Mehri / Vos, Margreet C / Knight, Gwenan M / van Wamel, Willem J B

    Microbiology spectrum

    2022  Volume 10, Issue 5, Page(s) e0061522

    Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) clusters are considered epidemic or nonepidemic based on their ability to spread effectively. Successful transmission could be influenced by dehydration tolerance. Current methods for determination of ... ...

    Abstract Methicillin-resistant Staphylococcus aureus (MRSA) clusters are considered epidemic or nonepidemic based on their ability to spread effectively. Successful transmission could be influenced by dehydration tolerance. Current methods for determination of dehydration tolerance lack accuracy. Here, a climate-controlled
    MeSH term(s) Humans ; Methicillin-Resistant Staphylococcus aureus ; Staphylococcus aureus ; Staphylococcal Infections/microbiology ; Dehydration ; France ; Anti-Bacterial Agents/pharmacology
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-08-16
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2807133-5
    ISSN 2165-0497 ; 2165-0497
    ISSN (online) 2165-0497
    ISSN 2165-0497
    DOI 10.1128/spectrum.00615-22
    Database MEDical Literature Analysis and Retrieval System OnLINE

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