Seminar | Timeline sampling of individual patients reveals 
positive selection and co-selection of antibiotic resistance

Co-hosted between the AMR Centre and CMMID Centre


Antibiotic resistant bacteria of the Enterobacteriaceae family are a major threat to public health. Enterobacteriaceae are common, gram-negative members of the human gut microbiota who can turn into life-threatening blood infections that require treatment with antibiotics. In a recent worldwide endemic of the CTX-m resistance gene, a significant proportion of Enterobacteriaceae has become resistant to important first-line antibiotics, leading to increased treatment costs and patient mortality. While antibiotics are crucial for the treatment of bacterial infections, it is clear that we must employ them better to stop the spread of highly resistant pathogens. However, we lack quantitative insights into the impact of antibiotics on within host resistance to guide evidence-based usage of antibiotics.

Here, we analyse individual patient timelines of CTX-m gene quantitative PCR measurements from follow-up stool samples. We build a mechanistic Bayesian model of the CTX-m dynamics and study how treatment with different antibiotics impacts resistance gene levels. The data suggests that both direct natural selection and co-selection can contribute significantly to the spread of resistance through standard antibiotics. To improve standard treatment, we need a better understanding of how antibiotics influence antibiotic resistance in patients.


Speaker: Rene Niehus (Mahidol-Oxford Tropical Medicine Research Unit, Bangkok)

Date: 20 March 2018

Time: 12:45 – 14:00

Venue: John Snow B, Keppel Street

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