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revised as.rsi(), fix for mdro()

This commit is contained in:
2022-11-24 20:29:00 +01:00
parent 05d536ebb7
commit 31fb81c382
10 changed files with 450 additions and 453 deletions

415
R/mdro.R
View File

@ -193,13 +193,17 @@ mdro <- function(x = NULL,
meet_criteria(combine_SI, allow_class = "logical", has_length = 1)
meet_criteria(verbose, allow_class = "logical", has_length = 1)
meet_criteria(only_rsi_columns, allow_class = "logical", has_length = 1)
if (!any(is.rsi.eligible(x))) {
stop_("There were no possible R/SI columns found in the data set. Transform columns with `as.rsi()` for valid antimicrobial interpretations.")
}
info.bak <- info
# don't thrown info's more than once per call
if (isTRUE(info)) {
info <- message_not_thrown_before("mdro")
}
if (interactive() && isTRUE(verbose) && isTRUE(info)) {
txt <- paste0(
"WARNING: In Verbose mode, the mdro() function does not return the MDRO results, but instead returns a data set in logbook form with extensive info about which isolates would be MDRO-positive, or why they are not.",
@ -217,7 +221,7 @@ mdro <- function(x = NULL,
return(x)
}
}
group_msg <- ""
if (isTRUE(info.bak)) {
# print group name if used in dplyr::group_by()
@ -239,15 +243,15 @@ mdro <- function(x = NULL,
}
}
}
# force regular [data.frame], not a tibble or data.table
x <- as.data.frame(x, stringsAsFactors = FALSE)
if (pct_required_classes > 1) {
# allow pct_required_classes = 75 -> pct_required_classes = 0.75
pct_required_classes <- pct_required_classes / 100
}
guideline.bak <- guideline
if (is.list(guideline)) {
# Custom MDRO guideline ---------------------------------------------------
@ -256,8 +260,8 @@ mdro <- function(x = NULL,
txt <- paste0(
"Determining MDROs based on custom rules",
ifelse(isTRUE(attributes(guideline)$as_factor),
paste0(", resulting in factor levels: ", paste0(attributes(guideline)$values, collapse = " < ")),
""
paste0(", resulting in factor levels: ", paste0(attributes(guideline)$values, collapse = " < ")),
""
),
"."
)
@ -310,7 +314,7 @@ mdro <- function(x = NULL,
"invalid guideline: ", guideline.bak
)
guideline <- list(code = guideline)
# try to find columns based on type
# -- mo
if (is.null(col_mo)) {
@ -325,55 +329,55 @@ mdro <- function(x = NULL,
col_mo <- "mo"
}
stop_if(is.null(col_mo), "`col_mo` must be set")
if (guideline$code == "cmi2012") {
guideline$name <- "Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance."
guideline$author <- "Magiorakos AP, Srinivasan A, Carey RB, ..., Vatopoulos A, Weber JT, Monnet DL"
guideline$version <- NA
guideline$source_url <- "Clinical Microbiology and Infection 18:3, 2012; doi: 10.1111/j.1469-0691.2011.03570.x"
guideline$source_url <- paste0("Clinical Microbiology and Infection 18:3, 2012; ", font_url("https://doi.org/10.1111/j.1469-0691.2011.03570.x", "doi: 10.1111/j.1469-0691.2011.03570.x"))
guideline$type <- "MDRs/XDRs/PDRs"
} else if (guideline$code == "eucast3.1") {
guideline$name <- "EUCAST Expert Rules, \"Intrinsic Resistance and Exceptional Phenotypes Tables\""
guideline$author <- "EUCAST (European Committee on Antimicrobial Susceptibility Testing)"
guideline$version <- "3.1, 2016"
guideline$source_url <- "https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Expert_Rules/Expert_rules_intrinsic_exceptional_V3.1.pdf"
guideline$source_url <- font_url("https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Expert_Rules/Expert_rules_intrinsic_exceptional_V3.1.pdf", "Direct download")
guideline$type <- "EUCAST Exceptional Phenotypes"
} else if (guideline$code == "eucast3.2") {
guideline$name <- "EUCAST Expert Rules, \"Intrinsic Resistance and Unusual Phenotypes\""
guideline$author <- "EUCAST (European Committee on Antimicrobial Susceptibility Testing)"
guideline$version <- "3.2, February 2020"
guideline$source_url <- "https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Expert_Rules/2020/Intrinsic_Resistance_and_Unusual_Phenotypes_Tables_v3.2_20200225.pdf"
guideline$source_url <- font_url("https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Expert_Rules/2020/Intrinsic_Resistance_and_Unusual_Phenotypes_Tables_v3.2_20200225.pdf", "Direct download")
guideline$type <- "EUCAST Unusual Phenotypes"
} else if (guideline$code == "eucast3.3") {
guideline$name <- "EUCAST Expert Rules, \"Intrinsic Resistance and Unusual Phenotypes\""
guideline$author <- "EUCAST (European Committee on Antimicrobial Susceptibility Testing)"
guideline$version <- "3.3, October 2021"
guideline$source_url <- "https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Expert_Rules/2021/Intrinsic_Resistance_and_Unusual_Phenotypes_Tables_v3.3_20211018.pdf"
guideline$source_url <- font_url("https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Expert_Rules/2021/Intrinsic_Resistance_and_Unusual_Phenotypes_Tables_v3.3_20211018.pdf", "Direct download")
guideline$type <- "EUCAST Unusual Phenotypes"
} else if (guideline$code == "tb") {
guideline$name <- "Companion handbook to the WHO guidelines for the programmatic management of drug-resistant tuberculosis"
guideline$author <- "WHO (World Health Organization)"
guideline$version <- "WHO/HTM/TB/2014.11, 2014"
guideline$source_url <- "https://www.who.int/publications/i/item/9789241548809"
guideline$source_url <- font_url("https://www.who.int/publications/i/item/9789241548809", "Direct download")
guideline$type <- "MDR-TB's"
# support per country:
} else if (guideline$code == "mrgn") {
guideline$name <- "Cross-border comparison of the Dutch and German guidelines on multidrug-resistant Gram-negative microorganisms"
guideline$author <- "M\u00fcller J, Voss A, K\u00f6ck R, ..., Kern WV, Wendt C, Friedrich AW"
guideline$version <- NA
guideline$source_url <- "Antimicrobial Resistance and Infection Control 4:7, 2015; doi: 10.1186/s13756-015-0047-6"
guideline$source_url <- paste0("Antimicrobial Resistance and Infection Control 4:7, 2015; ", font_url("https://doi.org/10.1186/s13756-015-0047-6", "doi: 10.1186/s13756-015-0047-6"))
guideline$type <- "MRGNs"
} else if (guideline$code == "brmo") {
guideline$name <- "WIP-Richtlijn Bijzonder Resistente Micro-organismen (BRMO)"
guideline$author <- "RIVM (Rijksinstituut voor de Volksgezondheid)"
guideline$version <- "Revision as of December 2017"
guideline$source_url <- "https://www.rivm.nl/Documenten_en_publicaties/Professioneel_Praktisch/Richtlijnen/Infectieziekten/WIP_Richtlijnen/WIP_Richtlijnen/Ziekenhuizen/WIP_richtlijn_BRMO_Bijzonder_Resistente_Micro_Organismen_ZKH"
guideline$source_url <- font_url("https://www.rivm.nl/Documenten_en_publicaties/Professioneel_Praktisch/Richtlijnen/Infectieziekten/WIP_Richtlijnen/WIP_Richtlijnen/Ziekenhuizen/WIP_richtlijn_BRMO_Bijzonder_Resistente_Micro_Organismen_ZKH", "Direct download")
guideline$type <- "BRMOs"
} else {
stop("This guideline is currently unsupported: ", guideline$code, call. = FALSE)
}
if (guideline$code == "cmi2012") {
cols_ab <- get_column_abx(
x = x,
@ -618,7 +622,7 @@ mdro <- function(x = NULL,
}
cols_ab <- c(cols_ab, c(AMP = unname(cols_ab[names(cols_ab) == "AMX"])))
}
# nolint start
AMC <- cols_ab["AMC"]
AMK <- cols_ab["AMK"]
@ -763,13 +767,13 @@ mdro <- function(x = NULL,
abx_tb <- abx_tb[!is.na(abx_tb)]
stop_if(guideline$code == "tb" & length(abx_tb) == 0, "no antimycobacterials found in data set")
# nolint end
if (isTRUE(combine_SI)) {
search_result <- "R"
} else {
search_result <- c("R", "I")
}
if (isTRUE(info)) {
if (isTRUE(combine_SI)) {
cat(font_red("\nOnly results with 'R' are considered as resistance. Use `combine_SI = FALSE` to also consider 'I' as resistance.\n"))
@ -777,18 +781,18 @@ mdro <- function(x = NULL,
cat(font_red("\nResults with 'R' or 'I' are considered as resistance. Use `combine_SI = TRUE` to only consider 'R' as resistance.\n"))
}
cat("\n", word_wrap("Determining multidrug-resistant organisms (MDRO), according to:"), "\n",
word_wrap(paste0(font_bold("Guideline: "), font_italic(guideline$name)), extra_indent = 11, as_note = FALSE), "\n",
word_wrap(paste0(font_bold("Author(s): "), guideline$author), extra_indent = 11, as_note = FALSE), "\n",
ifelse(!is.na(guideline$version),
paste0(word_wrap(paste0(font_bold("Version: "), guideline$version), extra_indent = 11, as_note = FALSE), "\n"),
""
),
paste0(font_bold("Source: "), guideline$source_url),
"\n\n",
sep = ""
word_wrap(paste0(font_bold("Guideline: "), font_italic(guideline$name)), extra_indent = 11, as_note = FALSE), "\n",
word_wrap(paste0(font_bold("Author(s): "), guideline$author), extra_indent = 11, as_note = FALSE), "\n",
ifelse(!is.na(guideline$version),
paste0(word_wrap(paste0(font_bold("Version: "), guideline$version), extra_indent = 11, as_note = FALSE), "\n"),
""
),
paste0(font_bold("Source: "), guideline$source_url),
"\n\n",
sep = ""
)
}
ab_missing <- function(ab) {
isTRUE(ab %in% c(NULL, NA)) | length(ab) == 0
}
@ -800,7 +804,7 @@ mdro <- function(x = NULL,
out[is.na(out)] <- FALSE
out
}
# antibiotic classes
# nolint start
aminoglycosides <- c(TOB, GEN)
@ -811,7 +815,7 @@ mdro <- function(x = NULL,
carbapenems <- c(DOR, ETP, IPM, MEM, MEV)
fluoroquinolones <- c(CIP, ENX, FLE, GAT, GEM, GRX, LVX, LOM, MFX, NOR, OFX, PAZ, PEF, PRU, RFL, SPX, TMX, TVA)
# nolint end
# helper function for editing the table
trans_tbl <- function(to, rows, cols, any_all) {
cols <- cols[!ab_missing(cols)]
@ -840,14 +844,14 @@ mdro <- function(x = NULL,
)
}
)
if (any_all == "any") {
search_function <- any
} else if (any_all == "all") {
search_function <- all
}
x_transposed <- as.list(as.data.frame(t(x[, cols, drop = FALSE]),
stringsAsFactors = FALSE
stringsAsFactors = FALSE
))
rows_affected <- vapply(
FUN.VALUE = logical(1),
@ -866,7 +870,7 @@ mdro <- function(x = NULL,
)
}
}
trans_tbl2 <- function(txt, rows, lst) {
if (isTRUE(info)) {
message_(txt, "...", appendLF = FALSE, as_note = FALSE)
@ -874,6 +878,9 @@ mdro <- function(x = NULL,
if (length(rows) > 0) {
# function specific for the CMI paper of 2012 (Magiorakos et al.)
lst_vector <- unlist(lst)[!is.na(unlist(lst))]
# keep only unique ones:
lst_vector <- lst_vector[!duplicated(paste(lst_vector, names(lst_vector)))]
x[, lst_vector] <- as.data.frame(lapply(
x[, lst_vector, drop = FALSE],
function(col) as.rsi(col)
@ -892,7 +899,7 @@ mdro <- function(x = NULL,
))
}
)
if (isTRUE(verbose)) {
x[rows, "columns_nonsusceptible"] <<- vapply(
FUN.VALUE = character(1),
@ -920,17 +927,17 @@ mdro <- function(x = NULL,
)
# for PDR; all drugs are R (or I if combine_SI = FALSE)
x_transposed <- as.list(as.data.frame(t(x[rows, lst_vector, drop = FALSE]),
stringsAsFactors = FALSE
stringsAsFactors = FALSE
))
row_filter <- vapply(FUN.VALUE = logical(1), x_transposed, function(y) all(y %in% search_result, na.rm = TRUE))
x[which(row_filter), "classes_affected"] <<- 999
}
if (isTRUE(info)) {
message_(" OK.", add_fn = list(font_green, font_bold), as_note = FALSE)
}
}
x[, col_mo] <- as.mo(as.character(x[, col_mo, drop = TRUE]))
# rename col_mo to prevent interference with joined columns
colnames(x)[colnames(x) == col_mo] <- ".col_mo"
@ -941,12 +948,12 @@ mdro <- function(x = NULL,
x$row_number <- seq_len(nrow(x))
x$reason <- paste0("not covered by ", toupper(guideline$code), " guideline")
x$columns_nonsusceptible <- ""
if (guideline$code == "cmi2012") {
# CMI, 2012 ---------------------------------------------------------------
# Non-susceptible = R and I
# (see header 'Approaches to Creating Definitions for MDR, XDR and PDR' in paper)
# take amoxicillin if ampicillin is unavailable
if (is.na(AMP) && !is.na(AMX)) {
if (isTRUE(verbose)) {
@ -967,87 +974,87 @@ mdro <- function(x = NULL,
}
CTX <- CRO
}
# intrinsic resistant must not be considered for the determination of MDR,
# so let's just remove them, meticulously following the paper
x[which(x$genus == "Enterococcus" & x$species == "faecium"), ab_NA(IPM)] <- NA
x[which(x$genus == "Enterococcus" & x$species == "faecalis"), ab_NA(QDA)] <- NA
x[which((x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii")), ab_NA(c(GEN, TOB, NET))] <- NA
(x$genus == "Providencia" & x$species == "stuartii")), ab_NA(c(GEN, TOB, NET))] <- NA
x[which(x$genus == "Escherichia" & x$species == "hermannii"), ab_NA(c(TCC, TZP))] <- NA
x[which((x$genus == "Citrobacter" & x$species == "freundii") |
(x$genus == "Enterobacter" & x$species == "aerogenes") |
(x$genus == "Klebsiella" & x$species == "aerogenes") # new name (2017)
| (x$genus == "Enterobacter" & x$species == "cloacae") |
(x$genus == "Hafnia" & x$species == "alvei") |
(x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(CZO)] <- NA
(x$genus == "Enterobacter" & x$species == "aerogenes") |
(x$genus == "Klebsiella" & x$species == "aerogenes") # new name (2017)
| (x$genus == "Enterobacter" & x$species == "cloacae") |
(x$genus == "Hafnia" & x$species == "alvei") |
(x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(CZO)] <- NA
x[which((x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(CXM)] <- NA
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(CXM)] <- NA
x[which((x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Proteus" & x$species == "mirabilis") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii")), ab_NA(TGC)] <- NA
(x$genus == "Proteus" & x$species == "mirabilis") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii")), ab_NA(TGC)] <- NA
x[which((x$genus == "Citrobacter" & x$species == "koseri") |
(x$genus == "Citrobacter" & x$species == "freundii") |
(x$genus == "Enterobacter" & x$species == "aerogenes") |
(x$genus == "Klebsiella" & x$species == "aerogenes") # new name (2017)
| (x$genus == "Enterobacter" & x$species == "cloacae") |
(x$genus == "Escherichia" & x$species == "hermannii") |
(x$genus == "Hafnia" & x$species == "alvei") |
(x$genus == "Klebsiella") |
(x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(AMP)] <- NA
(x$genus == "Citrobacter" & x$species == "freundii") |
(x$genus == "Enterobacter" & x$species == "aerogenes") |
(x$genus == "Klebsiella" & x$species == "aerogenes") # new name (2017)
| (x$genus == "Enterobacter" & x$species == "cloacae") |
(x$genus == "Escherichia" & x$species == "hermannii") |
(x$genus == "Hafnia" & x$species == "alvei") |
(x$genus == "Klebsiella") |
(x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(AMP)] <- NA
x[which((x$genus == "Citrobacter" & x$species == "freundii") |
(x$genus == "Enterobacter" & x$species == "aerogenes") |
(x$genus == "Klebsiella" & x$species == "aerogenes") # new name (2017)
| (x$genus == "Enterobacter" & x$species == "cloacae") |
(x$genus == "Hafnia" & x$species == "alvei") |
(x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(AMC)] <- NA
(x$genus == "Enterobacter" & x$species == "aerogenes") |
(x$genus == "Klebsiella" & x$species == "aerogenes") # new name (2017)
| (x$genus == "Enterobacter" & x$species == "cloacae") |
(x$genus == "Hafnia" & x$species == "alvei") |
(x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(AMC)] <- NA
x[which((x$genus == "Citrobacter" & x$species == "freundii") |
(x$genus == "Citrobacter" & x$species == "koseri") |
(x$genus == "Enterobacter" & x$species == "aerogenes") |
(x$genus == "Klebsiella" & x$species == "aerogenes") # new name (2017)
| (x$genus == "Enterobacter" & x$species == "cloacae") |
(x$genus == "Hafnia" & x$species == "alvei") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(SAM)] <- NA
(x$genus == "Citrobacter" & x$species == "koseri") |
(x$genus == "Enterobacter" & x$species == "aerogenes") |
(x$genus == "Klebsiella" & x$species == "aerogenes") # new name (2017)
| (x$genus == "Enterobacter" & x$species == "cloacae") |
(x$genus == "Hafnia" & x$species == "alvei") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(SAM)] <- NA
x[which((x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Proteus" & x$species == "mirabilis") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(COL)] <- NA
(x$genus == "Proteus" & x$species == "mirabilis") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii") |
(x$genus == "Serratia" & x$species == "marcescens")), ab_NA(COL)] <- NA
x[which((x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Proteus" & x$species == "mirabilis") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii")), ab_NA(TCY)] <- NA
(x$genus == "Proteus" & x$species == "mirabilis") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii")), ab_NA(TCY)] <- NA
x[which((x$genus == "Morganella" & x$species == "morganii") |
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii")), ab_NA(c(DOX, MNO))] <- NA
(x$genus == "Proteus" & x$species == "penneri") |
(x$genus == "Proteus" & x$species == "vulgaris") |
(x$genus == "Providencia" & x$species == "rettgeri") |
(x$genus == "Providencia" & x$species == "stuartii")), ab_NA(c(DOX, MNO))] <- NA
x$classes_in_guideline <- NA_integer_
x$classes_available <- NA_integer_
x$classes_affected <- NA_integer_
# now add the MDR levels to the data
trans_tbl(
2,
@ -1149,7 +1156,7 @@ mdro <- function(x = NULL,
c(TCY, DOX, MNO)
)
)
# now set MDROs:
# MDR (=2): >=3 classes affected
x[which(x$classes_affected >= 3), "MDRO"] <- 2
@ -1161,7 +1168,7 @@ mdro <- function(x = NULL,
" out of ", x$classes_available[which(x$classes_affected >= 3)], " available classes"
)
}
# XDR (=3): all but <=2 classes affected
x[which((x$classes_in_guideline - x$classes_affected) <= 2), "MDRO"] <- 3
if (isTRUE(verbose)) {
@ -1170,7 +1177,7 @@ mdro <- function(x = NULL,
" out of ", x$classes_in_guideline[which(x$MDRO == 3)], " classes)"
)
}
# PDR (=4): all drugs are R
x[which(x$classes_affected == 999 & x$classes_in_guideline == x$classes_available), "MDRO"] <- 4
if (isTRUE(verbose)) {
@ -1181,7 +1188,7 @@ mdro <- function(x = NULL,
ifelse(!isTRUE(combine_SI), " or I", "")
)
}
# not enough classes available
x[which(x$MDRO %in% c(1, 3) & x$classes_available < floor(x$classes_in_guideline * pct_required_classes)), "MDRO"] <- -1
if (isTRUE(verbose)) {
@ -1191,18 +1198,18 @@ mdro <- function(x = NULL,
" (~", percentage(pct_required_classes), " of ", x$classes_in_guideline[which(x$MDRO == -1)], ")"
)
}
# add antibiotic names of resistant ones to verbose output
}
if (guideline$code == "eucast3.1") {
# EUCAST 3.1 --------------------------------------------------------------
# Table 5
trans_tbl(
3,
which(x$order == "Enterobacterales" |
(x$genus == "Pseudomonas" & x$species == "aeruginosa") |
x$genus == "Acinetobacter"),
(x$genus == "Pseudomonas" & x$species == "aeruginosa") |
x$genus == "Acinetobacter"),
COL,
"all"
)
@ -1287,17 +1294,17 @@ mdro <- function(x = NULL,
"any"
)
}
if (guideline$code == "eucast3.2") {
# EUCAST 3.2 --------------------------------------------------------------
# Table 6
trans_tbl(
3,
which((x$order == "Enterobacterales" &
!x$family == "Morganellaceae" &
!(x$genus == "Serratia" & x$species == "marcescens")) |
(x$genus == "Pseudomonas" & x$species == "aeruginosa") |
x$genus == "Acinetobacter"),
!x$family == "Morganellaceae" &
!(x$genus == "Serratia" & x$species == "marcescens")) |
(x$genus == "Pseudomonas" & x$species == "aeruginosa") |
x$genus == "Acinetobacter"),
COL,
"all"
)
@ -1388,7 +1395,7 @@ mdro <- function(x = NULL,
"any"
)
}
if (guideline$code == "eucast3.3") {
# EUCAST 3.3 --------------------------------------------------------------
# note: this guideline is equal to EUCAST 3.2 - no MDRO insights changed
@ -1396,10 +1403,10 @@ mdro <- function(x = NULL,
trans_tbl(
3,
which((x$order == "Enterobacterales" &
!x$family == "Morganellaceae" &
!(x$genus == "Serratia" & x$species == "marcescens")) |
(x$genus == "Pseudomonas" & x$species == "aeruginosa") |
x$genus == "Acinetobacter"),
!x$family == "Morganellaceae" &
!(x$genus == "Serratia" & x$species == "marcescens")) |
(x$genus == "Pseudomonas" & x$species == "aeruginosa") |
x$genus == "Acinetobacter"),
COL,
"all"
)
@ -1490,72 +1497,72 @@ mdro <- function(x = NULL,
"any"
)
}
if (guideline$code == "mrgn") {
# Germany -----------------------------------------------------------------
# Table 1
trans_tbl(
2, # 3MRGN
which((x$order == "Enterobacterales" | # following in fact the old Enterobacteriaceae classification
(x$genus == "Acinetobacter" & x$species == "baumannii")) &
try_ab(x[, PIP, drop = TRUE] == "R") &
(try_ab(x[, CTX, drop = TRUE] == "R") | try_ab(x[, CAZ, drop = TRUE] == "R")) &
(try_ab(x[, IPM, drop = TRUE] != "R") | try_ab(x[, MEM, drop = TRUE] != "R")) &
try_ab(x[, CIP, drop = TRUE] == "R")),
(x$genus == "Acinetobacter" & x$species == "baumannii")) &
try_ab(x[, PIP, drop = TRUE] == "R") &
(try_ab(x[, CTX, drop = TRUE] == "R") | try_ab(x[, CAZ, drop = TRUE] == "R")) &
(try_ab(x[, IPM, drop = TRUE] != "R") | try_ab(x[, MEM, drop = TRUE] != "R")) &
try_ab(x[, CIP, drop = TRUE] == "R")),
c(PIP, CTX, CAZ, IPM, MEM, CIP),
"any"
)
trans_tbl(
3, # 4MRGN, overwrites 3MRGN if applicable
which((x$order == "Enterobacterales" | # following in fact the old Enterobacteriaceae classification
(x$genus == "Acinetobacter" & x$species == "baumannii")) &
try_ab(x[, PIP, drop = TRUE] == "R") &
(try_ab(x[, CTX, drop = TRUE] == "R") | try_ab(x[, CAZ, drop = TRUE] == "R")) &
(try_ab(x[, IPM, drop = TRUE] == "R") | try_ab(x[, MEM, drop = TRUE] == "R")) &
try_ab(x[, CIP, drop = TRUE] == "R")),
(x$genus == "Acinetobacter" & x$species == "baumannii")) &
try_ab(x[, PIP, drop = TRUE] == "R") &
(try_ab(x[, CTX, drop = TRUE] == "R") | try_ab(x[, CAZ, drop = TRUE] == "R")) &
(try_ab(x[, IPM, drop = TRUE] == "R") | try_ab(x[, MEM, drop = TRUE] == "R")) &
try_ab(x[, CIP, drop = TRUE] == "R")),
c(PIP, CTX, CAZ, IPM, MEM, CIP),
"any"
)
trans_tbl(
3, # 4MRGN, overwrites 3MRGN if applicable
which((x$order == "Enterobacterales" | # following in fact the old Enterobacteriaceae classification
(x$genus == "Acinetobacter" & x$species == "baumannii")) &
(try_ab(x[, IPM, drop = TRUE] == "R") | try_ab(x[, MEM, drop = TRUE] == "R"))),
(x$genus == "Acinetobacter" & x$species == "baumannii")) &
(try_ab(x[, IPM, drop = TRUE] == "R") | try_ab(x[, MEM, drop = TRUE] == "R"))),
c(IPM, MEM),
"any"
)
trans_tbl(
2, # 3MRGN, if only 1 group is S
which(x$genus == "Pseudomonas" & x$species == "aeruginosa" &
try_ab(x[, PIP, drop = TRUE] == "S") +
try_ab(x[, CTX, drop = TRUE] == "S") +
try_ab(x[, CAZ, drop = TRUE] == "S") +
try_ab(x[, IPM, drop = TRUE] == "S") +
try_ab(x[, MEM, drop = TRUE] == "S") +
try_ab(x[, CIP, drop = TRUE] == "S") == 1),
try_ab(x[, PIP, drop = TRUE] == "S") +
try_ab(x[, CTX, drop = TRUE] == "S") +
try_ab(x[, CAZ, drop = TRUE] == "S") +
try_ab(x[, IPM, drop = TRUE] == "S") +
try_ab(x[, MEM, drop = TRUE] == "S") +
try_ab(x[, CIP, drop = TRUE] == "S") == 1),
c(PIP, CTX, CAZ, IPM, MEM, CIP),
"any"
)
trans_tbl(
3, # 4MRGN otherwise
which((x$genus == "Pseudomonas" & x$species == "aeruginosa") &
try_ab(x[, PIP, drop = TRUE] == "R") &
(try_ab(x[, CTX, drop = TRUE] == "R") | try_ab(x[, CAZ, drop = TRUE] == "R")) &
(try_ab(x[, IPM, drop = TRUE] == "R") | try_ab(x[, MEM, drop = TRUE] == "R")) &
try_ab(x[, CIP, drop = TRUE] == "R")),
try_ab(x[, PIP, drop = TRUE] == "R") &
(try_ab(x[, CTX, drop = TRUE] == "R") | try_ab(x[, CAZ, drop = TRUE] == "R")) &
(try_ab(x[, IPM, drop = TRUE] == "R") | try_ab(x[, MEM, drop = TRUE] == "R")) &
try_ab(x[, CIP, drop = TRUE] == "R")),
c(PIP, CTX, CAZ, IPM, MEM, CIP),
"any"
)
x[which(x$MDRO == 2), "reason"] <- "3MRGN"
x[which(x$MDRO == 3), "reason"] <- "4MRGN"
}
if (guideline$code == "brmo") {
# Netherlands -------------------------------------------------------------
aminoglycosides <- aminoglycosides[!is.na(aminoglycosides)]
@ -1568,7 +1575,7 @@ mdro <- function(x = NULL,
if (length(ESBLs) != 2) {
ESBLs <- character(0)
}
# Table 1
trans_tbl(
3,
@ -1576,21 +1583,21 @@ mdro <- function(x = NULL,
c(aminoglycosides, fluoroquinolones),
"all"
)
trans_tbl(
2,
which(x$order == "Enterobacterales"), # following in fact the old Enterobacteriaceae classification
carbapenems,
"any"
)
trans_tbl(
2,
which(x$order == "Enterobacterales"), # following in fact the old Enterobacteriaceae classification
ESBLs,
"all"
)
# Table 2
trans_tbl(
2,
@ -1604,19 +1611,19 @@ mdro <- function(x = NULL,
c(aminoglycosides, fluoroquinolones),
"all"
)
trans_tbl(
3,
which(x$genus == "Stenotrophomonas" & x$species == "maltophilia"),
SXT,
"all"
)
if (!ab_missing(MEM) && !ab_missing(IPM) &&
!ab_missing(GEN) && !ab_missing(TOB) &&
!ab_missing(CIP) &&
!ab_missing(CAZ) &&
!ab_missing(TZP)) {
!ab_missing(GEN) && !ab_missing(TOB) &&
!ab_missing(CIP) &&
!ab_missing(CAZ) &&
!ab_missing(TZP)) {
x$psae <- 0
x[which(x[, MEM, drop = TRUE] == "R" | x[, IPM, drop = TRUE] == "R"), "psae"] <- 1 + x[which(x[, MEM, drop = TRUE] == "R" | x[, IPM, drop = TRUE] == "R"), "psae"]
x[which(x[, GEN, drop = TRUE] == "R" & x[, TOB, drop = TRUE] == "R"), "psae"] <- 1 + x[which(x[, GEN, drop = TRUE] == "R" & x[, TOB, drop = TRUE] == "R"), "psae"]
@ -1636,7 +1643,7 @@ mdro <- function(x = NULL,
x$genus == "Pseudomonas" & x$species == "aeruginosa" &
x$psae >= 3
), "reason"] <- paste0("at least 3 classes contain R", ifelse(!isTRUE(combine_SI), " or I", ""))
# Table 3
trans_tbl(
3,
@ -1657,7 +1664,7 @@ mdro <- function(x = NULL,
"all"
)
}
if (guideline$code == "tb") {
# Tuberculosis ------------------------------------------------------------
prepare_drug <- function(ab) {
@ -1694,7 +1701,7 @@ mdro <- function(x = NULL,
ab != "R"
}
}
x$mono_count <- 0
x[drug_is_R(INH), "mono_count"] <- x[drug_is_R(INH), "mono_count", drop = TRUE] + 1
x[drug_is_R(RIF), "mono_count"] <- x[drug_is_R(RIF), "mono_count", drop = TRUE] + 1
@ -1702,7 +1709,7 @@ mdro <- function(x = NULL,
x[drug_is_R(PZA), "mono_count"] <- x[drug_is_R(PZA), "mono_count", drop = TRUE] + 1
x[drug_is_R(RIB), "mono_count"] <- x[drug_is_R(RIB), "mono_count", drop = TRUE] + 1
x[drug_is_R(RFP), "mono_count"] <- x[drug_is_R(RFP), "mono_count", drop = TRUE] + 1
x$mono <- x$mono_count > 0
x$poly <- x$mono_count > 1 & drug_is_not_R(RIF) & drug_is_not_R(INH)
x$mdr <- drug_is_R(RIF) & drug_is_R(INH)
@ -1710,19 +1717,19 @@ mdro <- function(x = NULL,
x$second <- drug_is_R(CAP) | drug_is_R(KAN) | drug_is_R(AMK)
x$xdr <- x$mdr & x$xdr & x$second
x$MDRO <- ifelse(x$xdr, 5,
ifelse(x$mdr, 4,
ifelse(x$poly, 3,
ifelse(x$mono, 2,
1
)
)
)
ifelse(x$mdr, 4,
ifelse(x$poly, 3,
ifelse(x$mono, 2,
1
)
)
)
)
# keep all real TB, make other species NA
x$MDRO <- ifelse(x$fullname == "Mycobacterium tuberculosis", x$MDRO, NA_real_)
x$reason <- "PDR/MDR/XDR criteria were met"
}
# some more info on negative results
if (isTRUE(verbose)) {
if (guideline$code == "cmi2012") {
@ -1738,7 +1745,7 @@ mdro <- function(x = NULL,
x[which(x$MDRO == 1), "reason"] <- "too few antibiotics are R"
}
}
if (isTRUE(info.bak)) {
cat(group_msg)
if (sum(!is.na(x$MDRO)) == 0) {
@ -1750,11 +1757,11 @@ mdro <- function(x = NULL,
)))
}
}
# Fill in blanks ----
# for rows that have no results
x_transposed <- as.list(as.data.frame(t(x[, cols_ab, drop = FALSE]),
stringsAsFactors = FALSE
stringsAsFactors = FALSE
))
rows_empty <- which(vapply(
FUN.VALUE = logical(1),
@ -1768,7 +1775,7 @@ mdro <- function(x = NULL,
} else {
cat("\n")
}
# Results ----
if (guideline$code == "cmi2012") {
if (any(x$MDRO == -1, na.rm = TRUE)) {
@ -1815,7 +1822,7 @@ mdro <- function(x = NULL,
ordered = TRUE
)
}
if (isTRUE(verbose)) {
colnames(x)[colnames(x) == col_mo] <- "microorganism"
x$microorganism <- mo_name(x$microorganism, language = NULL)
@ -1837,9 +1844,9 @@ mdro <- function(x = NULL,
#' @export
custom_mdro_guideline <- function(..., as_factor = TRUE) {
meet_criteria(as_factor, allow_class = "logical", has_length = 1)
dots <- tryCatch(list(...),
error = function(e) "error"
error = function(e) "error"
)
stop_if(
identical(dots, "error"),
@ -1853,7 +1860,7 @@ custom_mdro_guideline <- function(..., as_factor = TRUE) {
inherits(dots[[i]], "formula"),
"rule ", i, " must be a valid formula input (e.g., using '~'), see `?mdro`"
)
# Query
qry <- dots[[i]][[2]]
if (inherits(qry, "call")) {
@ -1869,14 +1876,14 @@ custom_mdro_guideline <- function(..., as_factor = TRUE) {
qry <- gsub(" *([&|+-/*^><==]+) *", " \\1 ", qry)
qry <- gsub("'", "\"", qry, fixed = TRUE)
out[[i]]$query <- as.expression(qry)
# Value
val <- tryCatch(eval(dots[[i]][[3]]), error = function(e) NULL)
stop_if(is.null(val), "rule ", i, " must return a valid value, it now returns an error: ", tryCatch(eval(dots[[i]][[3]]), error = function(e) e$message))
stop_if(length(val) > 1, "rule ", i, " must return a value of length 1, not ", length(val))
out[[i]]$value <- as.character(val)
}
names(out) <- paste0("rule", seq_len(n_dots))
out <- set_clean_class(out, new_class = c("custom_mdro_guideline", "list"))
attr(out, "values") <- unname(c("Negative", vapply(FUN.VALUE = character(1), unclass(out), function(x) x$value)))
@ -1898,8 +1905,8 @@ c.custom_mdro_guideline <- function(x, ..., as_factor = NULL) {
}
for (g in list(...)) {
stop_ifnot(inherits(g, "custom_mdro_guideline"),
"for combining custom MDRO guidelines, all rules must be created with `custom_mdro_guideline()`",
call = FALSE
"for combining custom MDRO guidelines, all rules must be created with `custom_mdro_guideline()`",
call = FALSE
)
vals <- attributes(x)$values
if (!all(attributes(g)$values %in% vals)) {
@ -1949,28 +1956,28 @@ run_custom_mdro_guideline <- function(df, guideline, info) {
reasons <- character(length = NROW(df))
for (i in seq_len(n_dots)) {
qry <- tryCatch(eval(parse(text = guideline[[i]]$query), envir = df, enclos = parent.frame()),
error = function(e) {
AMR_env$err_msg <- e$message
return("error")
}
error = function(e) {
AMR_env$err_msg <- e$message
return("error")
}
)
if (identical(qry, "error")) {
warning_("in `custom_mdro_guideline()`: rule ", i,
" (`", as.character(guideline[[i]]$query), "`) was ignored because of this error message: ",
AMR_env$err_msg,
call = FALSE,
add_fn = font_red
" (`", as.character(guideline[[i]]$query), "`) was ignored because of this error message: ",
AMR_env$err_msg,
call = FALSE,
add_fn = font_red
)
next
}
stop_ifnot(is.logical(qry), "in custom_mdro_guideline(): rule ", i, " (`", guideline[[i]]$query,
"`) must return `TRUE` or `FALSE`, not ",
format_class(class(qry), plural = FALSE),
call = FALSE
"`) must return `TRUE` or `FALSE`, not ",
format_class(class(qry), plural = FALSE),
call = FALSE
)
new_mdros <- which(qry == TRUE & out == "")
if (isTRUE(info)) {
cat(word_wrap(
"- Custom MDRO rule ", i, ": `", as.character(guideline[[i]]$query),
@ -1986,11 +1993,11 @@ run_custom_mdro_guideline <- function(df, guideline, info) {
}
out[out == ""] <- "Negative"
reasons[out == "Negative"] <- "no rules matched"
if (isTRUE(attributes(guideline)$as_factor)) {
out <- factor(out, levels = attributes(guideline)$values, ordered = TRUE)
}
columns_nonsusceptible <- as.data.frame(t(df[, is.rsi(df), drop = FALSE] == "R"))
columns_nonsusceptible <- vapply(
FUN.VALUE = character(1),
@ -1998,7 +2005,7 @@ run_custom_mdro_guideline <- function(df, guideline, info) {
function(x) paste0(rownames(columns_nonsusceptible)[which(x)], collapse = " ")
)
columns_nonsusceptible[is.na(out)] <- NA_character_
data.frame(
row_number = seq_len(NROW(df)),
MDRO = out,