AMR Challenge

Antimicrobial resistance is a global problem that has so far resisted modern therapeutic interventions. Infections caused by gram-negative pathogens are a serious threat to public health worldwide, especially in Africa. The increasing incidence of multi-drug resistant (MDR) bacteria and the failure of carbapenem antimicrobial agents have triggered a shift to the use of colistin which is usually the last drug of choice for the treatment of serious bacterial infections. Colistin resistance has been reported in different regions of the world, particularly in Africa. Understanding the prevalence or trend of colistin resistance in pathogens from Africa will be crucial for developing new therapeutic interventions and for optimizing key regulatory policies, strengthening surveillance and stewardship for overall infection control. Without a doubt, colistin resistance is a critical medical issue that requires serious attention and proper monitoring, particularly in our setting. However, the trend and evolution of colistin resistance still remain elusive to date. Herein, we intend to leverage the ATLAS, Venatorx-GEAR, and other publicly available datasets to critically evaluate and model the evolution of resistance to colistin over time in Africa using the Bayesian hierarchical Gaussian mixture model. Firstly, we analyzed the percentage distribution and prevalence of antimicrobial resistance in different gram-negative pathogens (especially those of urgent priority according to WHO) to different antimicrobial agents. Thereafter, we analyzed and model the evolution of colistin resistance in Africa by evaluating the trends over the years in different clinical samples and different selected gram-negative pathogens. This study is very critical to modelling and tracking colistin resistance in Africa, and crucial in generating data that could aid in precision health care, inferring better treatment approaches for certain pathogens and strengthening baseline public health systems.