Faculty of Pharmacy, Osaka Ohtani University, Osaka, Japan.
Institute of Frontier Science and Technology, Okayama University of Science, Okayama, Japan.
J Clin Pharm Ther. 2022 Mar;47(3):345-359. doi: 10.1111/jcpt.13564. Epub 2021 Nov 24.
In our previous studies, we developed a cross-resistance rate (CRR) correlation diagram (CRR diagram) that visually captures the magnitude of CRRs between antimicrobials using scatter plots. We used asymmetric multidimensional scaling (MDS) to transform cross-resistance similarities between antimicrobials into a 2-dimensional map and attempted to visually express them. We also explored the antibiograms of Pseudomonas aeruginosa before and after the transfer to newly built hospitals, and we determined by the CRR diagram that the CRRs among β-lactam antimicrobials other than carbapenems decreased substantially with the facility transfer. The present study tests whether the analysis of CRRs by asymmetric MDS can be used as new visual information that is easy for healthcare professionals to understand.
We tested the impact of changes in the nosocomial environment due to institutional transfers on CRRs among antimicrobials in asymmetric MDS, as well as contrasted the asymmetric MDS map and CRR diagram.
In the asymmetric MDS map, antimicrobial groups with the same mechanism of action were displayed close together, and antimicrobial groups with different mechanisms of action were displayed separately. The asymmetric MDS map drawn solely for antimicrobials belonging to the group with the same mechanism of action showed similarities to the CRR diagram. Also, the distance of each antimicrobial to other antimicrobials shown in the asymmetric MDS map was negatively correlated with the CRRs for them against that antimicrobial.
The asymmetric MDS map expresses the dissimilarity as distances between agents, and there are no meanings or units on the ordinate and abscissa axes of the output map. In contrast, the CRR diagram expresses the antimicrobials' resistance status as values, such as resistance rate and CRR. By analysing the CRRs in the asymmetric MDS, it is feasible to visually recognize cross-resistance similarities between antimicrobial groups as distances. The use of the asymmetric MDS combined with the CRR diagram allows us to visually understand the resistance and cross-resistance status of each antimicrobial agent as a 2-dimensional map, as well as to understand the trends and characteristics of the data by means of quantitative values.
在我们之前的研究中，我们开发了一种交叉耐药率（CRR）相关图（CRR 图），通过散点图直观地捕捉抗生素之间 CRR 的大小。我们使用非对称多维尺度分析（MDS）将抗生素之间的交叉耐药相似性转化为二维地图，并试图直观地表达它们。我们还探索了铜绿假单胞菌在转移到新建医院前后的药敏谱，通过 CRR 图确定除碳青霉烯类以外的β-内酰胺类抗生素之间的 CRR 随着设施转移而显著降低。本研究检验了非对称 MDS 分析 CRR 是否可以作为新的视觉信息，便于医疗保健专业人员理解。
我们测试了由于机构转移导致医院环境变化对非对称 MDS 中抗生素之间 CRR 的影响，并对比了非对称 MDS 图谱和 CRR 图。
在非对称 MDS 图谱中，具有相同作用机制的抗生素组显示在一起，具有不同作用机制的抗生素组则分开显示。仅针对属于同一作用机制的抗生素组绘制的非对称 MDS 图谱与 CRR 图相似。此外，非对称 MDS 图谱中每个抗生素与其他抗生素的距离与它们对该抗生素的 CRR 呈负相关。
非对称 MDS 图谱通过 agents 之间的距离来表示差异，输出图谱的坐标轴上没有任何含义或单位。相比之下，CRR 图将抗生素的耐药状态表示为值，例如耐药率和 CRR。通过分析非对称 MDS 中的 CRR，可以将抗生素组之间的交叉耐药相似性视为距离进行直观识别。使用非对称 MDS 结合 CRR 图，可以将每个抗生素的耐药和交叉耐药状态直观地理解为二维图谱，并通过定量值了解数据的趋势和特征。
