Antimicrobial Resistance Prediction in Intensive Care Unit for Pseudomonas Aeruginosa using Temporal Data-Driven Models.

Authors

DOI:

https://doi.org/10.9781/ijimai.2021.02.012

Keywords:

Antimicrobial Resistance, Intensive Care Unit, Prediction, Pseudomonas Aeruginosa, Temporal Data-Driven Modeling
Supporting Agencies
We are thankful to the University Hospital of Fuenlabrada in Madrid, Spain, for providing us the database used in this research. This work has been partly supported by the Spanish Thematic Network “Learning Machines for Singular Problems and Applications (MAPAS)” (TIN2017-90567-REDT, MINECO/FEDER EU), by the IDEAI-UPC Consolidated Research Group Grant from Catalan Agency of University and Research Grants (AGAUR, Generalitat de Catalunya) (2017 SGR 574), by the Science and Innovation Ministry Grants Klinilycs (TEC2016-75361-R), AAVis-BMR (PID2019-107768RA-I00) and BigTheory (PID2019-106623RB-C41), by the Spanish Institute of Health Carlos III (grant DTS 17/00158), by Project Ref. F656 financed by Rey Juan Carlos University, and by the Youth Employment Initiative R&D Project (TIC-11649) financed by the Community of Madrid (Spain). Funded action by the Community of Madrid in the framework of the Multiannual Agreement with the Rey Juan Carlos University in line of action 1, “Encouragement of Young Phd students investigation” Project Ref. F661 Acronym Mapping-UCI.

Abstract

One threatening medical problem for human beings is the increasing antimicrobial resistance of some microorganisms. This problem is especially difficult in Intensive Care Units (ICUs) of hospitals due to the vulnerable state of patients. Knowing in advance whether a concrete bacterium is resistant or susceptible to an antibiotic is a crux step for clinicians to determine an effective antibiotic treatment. This usual clinical procedure takes approximately 48 hours and it is named antibiogram. It tests the bacterium resistance to one or more antimicrobial families (six of them considered in this work). This article focuses on cultures of the Pseudomonas Aeruginosa bacterium because is one of the most dangerous in the ICU. Several temporal data-driven models are proposed and analyzed to predict the resistance or susceptibility to a determined antibiotic family previously to know the antibiogram result and only using the available past information from a data set. This data set is formed by anonymized electronic health records data from more than 3300 ICU patients during 15 years. Several data-driven classifier methods are used in combination with several temporal modeling approaches. The results show that our predictions are reasonably accurate for some antimicrobial families, and could be used by clinicians to determine the best antibiotic therapy in advance. This early prediction can save valuable time to start the adequate treatment for an ICU patient. This study corroborates the results of a previous work pointing that the antimicrobial resistance of bacteria in the ICU is related to other recent resistance tests of ICU patients. This information is very valuable for making accurate antimicrobial resistance predictions.

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References

[1] W. H. Organization, et al., “Antimicrobial resistance,” Weekly Epidemiological Record= Relevé épidémiologique hebdomadaire, vol. 75, no. 41, pp. 336–336, 2000.

[2] Infectious Diseases Society of America (IDSA), “Combating antimicrobial resistance: policy recommendations to save lives,” Clinical Infectious Diseases, vol. 52, no. suppl_5, pp. S397–S428, 2011.

[3] M. Mendelson, M. P. Matsoso, “The world health organization global action plan for antimicrobial resistance,” SAMJ: South African Medical Journal, vol. 105, no. 5, pp. 325–325, 2015.

[4] B. K. English, A. H. Gaur, “The use and abuse of antibiotics and the development of antibiotic resistance,” in Hot topics in infection and immunity in children VI, Springer, 2010, pp. 73–82.

[5] S. Joshi, et al., “Hospital antibiogram: a necessity,” Indian journal of medical microbiology, vol. 28, no. 4, p. 277, 2010.

[6] A. Tsymbal, M. Pechenizkiy, P. Cunningham, S. Puuronen, “Handling local concept drift with dynamic integration of classifiers: Domain of antibiotic resistance in nosocomial infections,” in 19th IEEE Symposium on Computer-Based Medical Systems (CBMS’06), 2006, pp. 679–684, IEEE.

[7] A. Lorenz, M. Preuße, S. Bruchmann, V. Pawar, N. Grahl, M. C. Pils, L. M. Nolan, A. Filloux, S. Weiss, S. Häussler, “Importance of flagella in acute and chronic pseudomonas aeruginosa infections,” Environmental microbiology, vol. 21, no. 3, pp. 883–897, 2019.

[8] G. Meletis, M. Bagkeri, “Pseudomonas aeruginosa: Multi-drug-resistance development and treatment options,” Infection Control, pp. 33–56, 2013.

[9] M. W. Pesesky, T. Hussain, M. Wallace, S. Patel, S. Andleeb, C.-A. D. Burnham, G. Dantas, “Evaluation of machine learning and rulesbased approaches for predicting antimicrobial resistance profiles in gram-negative bacilli from whole genome sequence data,” Frontiers in microbiology, vol. 7, p. 1887, 2016.

[10] M. Ellington, O. Ekelund, F. M. Aarestrup, R. Canton, M. Doumith, C. Giske, H. Grundman, H. Hasman, M. Holden, K. L. Hopkins, et al., “The role of whole genome sequencing in antimicrobial susceptibility testing of bacteria: report from the eucast subcommittee,” Clinical microbiology and infection, vol. 23, no. 1, pp. 2–22, 2017.

[11] G. Arango-Argoty, E. Garner, A. Pruden, L. S. Heath, P. Vikesland, L. Zhang, “Deeparg: a deep learning approach for predicting antibiotic resistance genes from metagenomic data,” Microbiome, vol. 6, no. 1, pp. 1–15, 2018.

[12] M. Nguyen, S. W. Long, P. F. McDermott, R. J. Olsen, R. Olson, R. L. Stevens, G. H. Tyson, S. Zhao, J. J. Davis, “Using machine learning to predict antimicrobial mics and associated genomic features for nontyphoidal salmonella,” Journal of clinical microbiology, vol. 57, no. 2, 2019.

[13] M. Tlachac, E. A. Rundensteiner, K. Barton, S. Troppy, K. Beaulac, S. Doron, “Predicting future antibiotic susceptibility using regressionbased methods on longitudinal massachusetts antibiogram data.,” in HEALTHINF, 2018, pp. 103–114.

[14] S. Martínez-Agüero, I. Mora-Jiménez, J. Lérida-García, J. ÁlvarezRodríguez, C. Soguero-Ruiz, “Machine learning techniques to identify antimicrobial resistance in the intensive care unit,” Entropy, vol. 21, no. 6, p. 603, 2019.

[15] À. Hernàndez-Carnerero, M. Sànchez-Marrè, I. Mora-Jiménez, C. Soguero-Ruiz, S. Martínez-Agüero, J. Álvarez Rodríguez, “Modelling temporal relationships in pseudomonas aeruginosa antimicrobial resistance prediction in intensive care unit.,” in Proc. of Singular Problems for Health Care (SP4HC) Workshop at the 24th European Conference on Artificial Intelligence (ECAI 2020), 2020.

[16] S. Martínez-Agüero, I. Mora-Jiménez, A. García-Marqués, J. Álvarez Rodríguez, C. Soguero-Ruiz, “Applying lstm networks to predict multidrug resistance using binary multivariate clinical sequences,” in Proc. of Starting AI Researchers‘ Symposium (STAIRS) at the 24th European Conference on Artificial Intelligence (ECAI 2020), 2020.

[17] G. Eickelberg, L. N. Sanchez-Pinto, Y. Luo, “Predictive modeling of bacterial infections and antibiotic therapy needs in critically ill adults,” Journal of Biomedical Informatics, vol. 109, p. 103540, 2020.

[18] O. Lewin-Epstein, S. Baruch, L. Hadany, G. Y. Stein, U. Obolski, “Predicting antibiotic resistance in hospitalized patients by applying machine learning to electronic medical records,” Clinical Infectious Diseases.

[19] Ó. Escudero-Arnanz, I. Mora-Jiménez, S. Martínez-Agüero, J. Álvarez Rodríguez, C. Soguero-Ruiz, “Temporal feature selection for characterizing antimicrobialmultidrug resistance in the intensive care unit,” in Proc. of Singular Problems for Health Care (SP4HC) Workshop at the 24th European Conference on Artificial Intelligence (ECAI 2020), 2020.

[20] T. M. Cover, J. A. Thomas, “Elements of information theory,” 2012.

[21] A. T. Azar, H. I. Elshazly, A. E. Hassanien, A. M. Elkorany, “A random forest classifier for lymph diseases,” Computer methods and programs in biomedicine, vol. 113, no. 2, pp. 465–473, 2014.

[22] P. Revuelta-Zamorano, A. Sánchez, J. L. Rojo-Álvarez, J. ÁlvarezRodríguez, J. Ramos-López, C. Soguero-Ruiz, “Prediction of healthcare associated infections in an intensive care unit using machine learning and big data tools,” in XIV Mediterranean Conference on Medical and Biological Engineering and Computing 2016, 2016, pp. 840–845, Springer.

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2021-03-01
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How to Cite

Hernàndez Carnerero, Àlvar, Sànchez Marrè, M., Mora Jiménez, I., Soguero Ruiz, C., Martínez Agüero, S., and Álvarez Rodríguez, J. (2021). Antimicrobial Resistance Prediction in Intensive Care Unit for Pseudomonas Aeruginosa using Temporal Data-Driven Models. International Journal of Interactive Multimedia and Artificial Intelligence, 6(5), 119–133. https://doi.org/10.9781/ijimai.2021.02.012

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