# ==================================================================== # # TITLE # # Antimicrobial Resistance (AMR) Analysis # # # # AUTHORS # # Berends MS (m.s.berends@umcg.nl), Luz CF (c.f.luz@umcg.nl) # # # # LICENCE # # This program is free software; you can redistribute it and/or modify # # it under the terms of the GNU General Public License version 2.0, # # as published by the Free Software Foundation. # # # # This program is distributed in the hope that it will be useful, # # but WITHOUT ANY WARRANTY; without even the implied warranty of # # MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the # # GNU General Public License for more details. # # ==================================================================== # #' Dataset with 420 antibiotics #' #' A dataset containing all antibiotics with a J0 code, with their DDD's. Properties were downloaded from the WHO, see Source. #' @format A data.frame with 420 observations and 18 variables: #' \describe{ #' \item{\code{atc}}{ATC code, like \code{J01CR02}} #' \item{\code{molis}}{MOLIS code, like \code{amcl}} #' \item{\code{umcg}}{UMCG code, like \code{AMCL}} #' \item{\code{abbr}}{Abbreviation as used by many countries, to be used for \code{\link{guess_atc}}} #' \item{\code{official}}{Official name by the WHO, like \code{"Amoxicillin and enzyme inhibitor"}} #' \item{\code{official_nl}}{Official name in the Netherlands, like \code{"Amoxicilline met enzymremmer"}} #' \item{\code{trivial_nl}}{Trivial name in Dutch, like \code{"Amoxicilline/clavulaanzuur"}} #' \item{\code{trade_name}}{Trade name as used by many countries, to be used for \code{\link{guess_atc}}} #' \item{\code{oral_ddd}}{Defined Daily Dose (DDD), oral treatment} #' \item{\code{oral_units}}{Units of \code{ddd_units}} #' \item{\code{iv_ddd}}{Defined Daily Dose (DDD), parenteral treatment} #' \item{\code{iv_units}}{Units of \code{iv_ddd}} #' \item{\code{atc_group1}}{ATC group, like \code{"Macrolides, lincosamides and streptogramins"}} #' \item{\code{atc_group2}}{Subgroup of \code{atc_group1}, like \code{"Macrolides"}} #' \item{\code{atc_group1_nl}}{ATC group in Dutch, like \code{"Macroliden, lincosamiden en streptograminen"}} #' \item{\code{atc_group2_nl}}{Subgroup of \code{atc_group1} in Dutch, like \code{"Macroliden"}} #' \item{\code{useful_gramnegative}}{\code{FALSE} if not useful according to EUCAST, \code{NA} otherwise (see Source)} #' \item{\code{useful_grampositive}}{\code{FALSE} if not useful according to EUCAST, \code{NA} otherwise (see Source)} #' } #' @source - World Health Organization: \url{https://www.whocc.no/atc_ddd_index/} \cr - EUCAST - Expert rules intrinsic exceptional V3.1 \cr - MOLIS (LIS of Certe): \url{https://www.certe.nl} \cr - GLIMS (LIS of UMCG): \url{https://www.umcg.nl} #' @seealso \code{\link{microorganisms}} # abbr and trade_name created with: # https://hs.unr.edu/Documents/dhs/chs/NVPHTC/antibiotic_refeference_guide.pdf # antibiotics %>% # mutate(abbr = # case_when( # official == 'Amikacin' ~ 'Ak|AN|AMI|AMK', # official == 'Amoxicillin' ~ 'AMX|AMOX|AC', # official == 'Amoxicillin and beta-lactamase inhibitor' ~ 'AUG|A/C|XL|AML', # official == 'Ampicillin' ~ 'AM|AMP', # official == 'Ampicillin and beta-lactamase inhibitor' ~ 'A/S|SAM|AMS|AB', # official == 'Azithromycin' ~ 'Azi|AZM|AZ', # official == 'Azlocillin' ~ 'AZ|AZL', # official == 'Aztreonam' ~ 'Azt|ATM|AT|AZM', # official == 'Carbenicillin' ~ 'Cb|BAR', # official == 'Cefaclor' ~ 'Ccl|CEC|Cfr|FAC|CF', # official == 'Cefadroxil' ~ 'CFR|FAD', # official == 'Cefazolin' ~ 'Cfz|CZ|FAZ|KZ', # official == 'Cefdinir' ~ 'Cdn|CDR|DIN|CD|CFD', # official == 'Cefditoren' ~ 'CDN', # official == 'Cefepime' ~ 'Cpe|FEP|PM|CPM', # official == 'Cefixime' ~ 'Cfe|DCFM|FIX|IX', # official == 'Cefoperazone' ~ 'Cfp|CPZ|PER|FOP|CP', # official == 'Cefotaxime' ~ 'Cft|CTX|TAX|FOT|CT', # official == 'Cefotetan' ~ 'Ctn|CTT|CTE|TANS|CN', # official == 'Cefoxitin' ~ 'Cfx|FOX|CX|FX', # official == 'Cefpodoxime' ~ 'Cpd|POD|PX', # official == 'Cefprozil' ~ 'Cpz|CPR|FP', # official == 'Ceftaroline' ~ 'CPT', # official == 'Ceftazidime' ~ 'Caz|TAZ|TZ', # official == 'Ceftibuten' ~ 'CTB|TIB|CB', # official == 'Ceftizoxime' ~ 'Cz|ZOX|CZX|CZ|CTZ|TIZ', # official == 'Ceftriaxone' ~ 'Cax|CRO|CTR|FRX|AXO|TX', # official == 'Cefuroxime' ~ 'Crm|CXM|CFX|ROX|FUR|XM', # official == 'Cephalexin' ~ 'CN|LX|CFL', # official == 'Cephalothin' ~ 'Cf', # official == 'Chloramphenicol' ~ 'C|CHL|CL', # official == 'Ciprofloxacin' ~ 'Cp|CIP|CI', # official == 'Clarithromycin' ~ 'Cla|CLR|CLM|CH', # official == 'Clindamycin' ~ 'Cd|CC|CM|CLI|DA', # official == 'Colistin' ~ 'CL|CS|CT', # official == 'Daptomycin' ~ 'Dap', # official == 'Doxycycline' ~ 'Dox', # official == 'Doripenem' ~ 'DOR|Dor', # official == 'Ertapenem' ~ 'Etp', # official == 'Erythromycin' ~ 'E|ERY|EM', # official == 'Fosfomycin' ~ 'FOS|FF|FO|FM', # official == 'Flucloxacillin' ~ 'CLOX', # official == 'Gentamicin' ~ 'Gm|CN|GEN', # official == 'Imipenem' ~ 'Imp|IPM|IMI|IP', # official == 'Kanamycin' ~ 'K|KAN|HLK|KM', # official == 'Levofloxacin' ~ 'Lvx|LEV|LEVO|LE', # official == 'Linezolid' ~ 'Lzd|LNZ|LZ', # official == 'Lomefloxacin' ~ 'Lmf|LOM', # official == 'Meropenem' ~ 'Mer|MEM|MERO|MRP|MP', # official == 'Metronidazole' ~ 'MNZ', # official == 'Mezlocillin' ~ 'Mz|MEZ', # official == 'Minocycline' ~ 'Min|MI|MN|MNO|MC|MH', # official == 'Moxifloxacin' ~ 'Mox|MXF', # official == 'Mupirocin' ~ 'MUP', # official == 'Nafcillin' ~ 'Naf|NF', # official == 'Nalidixic acid' ~ 'NA|NAL', # official == 'Nitrofurantoin' ~ 'Fd|F/M|FT|NIT|NI|F', # official == 'Norfloxacin' ~ 'Nxn|NOR|NX', # official == 'Ofloxacin' ~ 'Ofl|OFX|OF', # official == 'Oxacillin' ~ 'Ox|OXS|OXA', # official == 'Benzylpenicillin' ~ 'P|PEN|PV', # official == 'Penicillins, combinations with other antibacterials' ~ 'P|PEN|PV', # official == 'Piperacillin' ~ 'Pi|PIP|PP', # official == 'Piperacillin and beta-lactamase inhibitor' ~ 'PT|TZP|PTZ|P/T|PTc', # official == 'Polymyxin B' ~ 'PB', # official == 'Quinupristin/dalfopristin' ~ 'Syn|Q/D|QDA|RP', # official == 'Rifampin' ~ 'Rif|RA|RI|RD', # official == 'Spectinomycin' ~ 'SPT|SPE|SC', # official == 'Streptomycin' ~ 'S|STR', # official == 'Teicoplanin' ~ 'Tei|TEC|TPN|TP|TPL', # official == 'Telavancin' ~ 'TLV', # official == 'Telithromcyin' ~ 'Tel', # official == 'Tetracycline' ~ 'Te|TET|TC', # official == 'Ticarcillin' ~ 'Ti|TIC|TC', # official == 'Ticarcillin and beta-lactamase inhibitor' ~ 'Tim|T/C|TCC|TLc', # official == 'Tigecycline' ~ 'TGC', # official == 'Tobramycin' ~ 'To|NN|TM|TOB', # official == 'Trimethoprim' ~ 'T|TMP|TR|W', # official == 'Sulfamethoxazole and trimethoprim' ~ 'T/S|SXT|SxT|TS|COT', # official == 'Vancomycin' ~ 'Va|VAN', # TRUE ~ NA_character_), # # trade_name = # case_when( # official == 'Amikacin' ~ 'Amikin', # official == 'Amoxicillin' ~ 'Amoxil|Dispermox|Larotid|Trimox', # official == 'Amoxicillin and beta-lactamase inhibitor' ~ 'Augmentin', # official == 'Ampicillin' ~ 'Pfizerpen-A|Principen', # official == 'Ampicillin and beta-lactamase inhibitor' ~ 'Unasyn', # official == 'Azithromycin' ~ 'Zithromax', # official == 'Azlocillin' ~ 'Azlin', # official == 'Aztreonam' ~ 'Azactam', # official == 'Carbenicillin' ~ 'Geocillin', # official == 'Cefaclor' ~ 'Ceclor', # official == 'Cefadroxil' ~ 'Duricef', # official == 'Cefazolin' ~ 'Ancef', # official == 'Cefdinir' ~ 'Omnicef', # official == 'Cefditoren' ~ 'Spectracef', # official == 'Cefepime' ~ 'Maxipime', # official == 'Cefixime' ~ 'Suprax', # official == 'Cefoperazone' ~ 'Cefobid', # official == 'Cefotaxime' ~ 'Claforan', # official == 'Cefotetan' ~ 'Cefotan', # official == 'Cefoxitin' ~ 'Mefoxin', # official == 'Cefpodoxime' ~ 'Vantin', # official == 'Cefprozil' ~ 'Cefzil', # official == 'Ceftaroline' ~ 'Teflaro', # official == 'Ceftazidime' ~ 'Fortaz|Tazicef|Tazidime', # official == 'Ceftibuten' ~ 'Cedax', # official == 'Ceftizoxime' ~ 'Cefizox', # official == 'Ceftriaxone' ~ 'Rocephin', # official == 'Cefuroxime' ~ 'Ceftin|Zinacef', # official == 'Cephalexin' ~ 'Keflex|Panixine', # official == 'Cephalothin' ~ 'Keflin', # official == 'Chloramphenicol' ~ 'Chloromycetin', # official == 'Ciprofloxacin' ~ 'Cipro|Ciloxan|Ciproxin', # official == 'Clarithromycin' ~ 'Biaxin', # official == 'Clindamycin' ~ 'Cleocin|Clinda-Derm|Clindagel|Clindesse|Clindets|Evoclin', # official == 'Colistin' ~ 'Coly-Mycin', # official == 'Daptomycin' ~ 'Cubicin', # official == 'Doxycycline' ~ 'Doryx|Monodox|Vibramycin|Atridox|Oracea|Periostat|Vibra-Tabs', # official == 'Doripenem' ~ 'Doribax', # official == 'Ertapenem' ~ 'Invanz', # official == 'Erythromycin' ~ 'Eryc|EryPed|Erythrocin|E-Base|E-Glades|E-Mycin|E.E.S.|Ery-Tab|Eryderm|Erygel|Erythra-derm|Eryzole|Pediamycin', # official == 'Fosfomycin' ~ 'Monurol', # official == 'Flucloxacillin' ~ 'Flopen|Floxapen|Fluclox|Sesamol|Softapen|Staphylex', # official == 'Gentamicin' ~ 'Garamycin|Genoptic', # official == 'Imipenem' ~ 'Primaxin', # official == 'Kanamycin' ~ 'Kantrex', # official == 'Levofloxacin' ~ 'Levaquin|Quixin', # official == 'Linezolid' ~ 'Zyvox', # official == 'Lomefloxacin' ~ 'Maxaquin', # official == 'Meropenem' ~ 'Merrem', # official == 'Metronidazole' ~ 'Flagyl|MetroGel|MetroCream|MetroLotion', # official == 'Mezlocillin' ~ 'Mezlin', # official == 'Minocycline' ~ 'Arestin|Solodyn', # official == 'Moxifloxacin' ~ 'Avelox|Vigamox', # official == 'Mupirocin' ~ 'Bactroban|Centany', # official == 'Nafcillin' ~ 'Unipen', # official == 'Nalidixic acid' ~ 'NegGram', # official == 'Nitrofurantoin' ~ 'Furadantin|Macrobid|Macrodantin', # official == 'Norfloxacin' ~ 'Noroxin', # official == 'Ofloxacin' ~ 'Floxin|Ocuflox|Ophthalmic', # official == 'Oxacillin' ~ 'Bactocill', # official == 'Benzylpenicillin' ~ 'Permapen|Pfizerpen|Veetids', # official == 'Penicillins, combinations with other antibacterials' ~ 'Permapen|Pfizerpen|Veetids', # official == 'Piperacillin' ~ 'Pipracil', # official == 'Piperacillin and beta-lactamase inhibitor' ~ 'Zosyn', # official == 'Polymyxin B' ~ 'Poly-RX', # official == 'Quinupristin/dalfopristin' ~ 'Synercid', # official == 'Rifampin' ~ 'Rifadin|Rifamate|Rimactane', # official == 'Spectinomycin' ~ 'Trobicin', # official == 'Streptomycin' ~ 'Streptomycin Sulfate', # official == 'Teicoplanin' ~ 'Targocid', # official == 'Telavancin' ~ 'Vibativ', # official == 'Telithromcyin' ~ 'Ketek', # official == 'Tetracycline' ~ 'Sumycin|Bristacycline|Tetrex', # official == 'Ticarcillin' ~ 'Ticar', # official == 'Ticarcillin and beta-lactamase inhibitor' ~ 'Timentin', # official == 'Tigecycline' ~ 'Tygacil', # official == 'Tobramycin' ~ 'Tobi|Aktob|Tobre', # official == 'Trimethoprim' ~ 'Primsol|Proloprim', # official == 'Sulfamethoxazole and trimethoprim' ~ 'Bactrim|Septra|Sulfatrim', # official == 'Vancomycin' ~ 'Vancocin|Vancomycin Hydrochloride', # TRUE ~ NA_character_) # ) # last two columns created with: # antibiotics %>% # mutate(useful_gramnegative = # if_else( # atc_group1 %like% '(fusidic|glycopeptide|macrolide|lincosamide|daptomycin|linezolid)' | # atc_group2 %like% '(fusidic|glycopeptide|macrolide|lincosamide|daptomycin|linezolid)' | # official %like% '(fusidic|glycopeptide|macrolide|lincosamide|daptomycin|linezolid)', # FALSE, # NA # ), # useful_grampositive = # if_else( # atc_group1 %like% '(aztreonam|temocillin|polymyxin|colistin|nalidixic)' | # atc_group2 %like% '(aztreonam|temocillin|polymyxin|colistin|nalidixic)' | # official %like% '(aztreonam|temocillin|polymyxin|colistin|nalidixic)', # FALSE, # NA # ) # ) "antibiotics" #' Dataset with ~2500 microorganisms #' #' A dataset containing 2453 microorganisms. MO codes of the UMCG can be looked up using \code{\link{microorganisms.umcg}}. #' @format A data.frame with 2453 observations and 12 variables: #' \describe{ #' \item{\code{bactid}}{ID of microorganism} #' \item{\code{bactsys}}{Bactsyscode of microorganism} #' \item{\code{family}}{Family name of microorganism} #' \item{\code{genus}}{Genus name of microorganism, like \code{"Echerichia"}} #' \item{\code{species}}{Species name of microorganism, like \code{"coli"}} #' \item{\code{subspecies}}{Subspecies name of bio-/serovar of microorganism, like \code{"EHEC"}} #' \item{\code{fullname}}{Full name, like \code{"Echerichia coli (EHEC)"}} #' \item{\code{type}}{Type of microorganism, like \code{"Bacteria"} and \code{"Fungus/yeast"}} #' \item{\code{gramstain}}{Gram of microorganism, like \code{"Negative rods"}} #' \item{\code{aerobic}}{Logical whether bacteria is aerobic} #' \item{\code{type_nl}}{Type of microorganism in Dutch, like \code{"Bacterie"} and \code{"Schimmel/gist"}} #' \item{\code{gramstain_nl}}{Gram of microorganism in Dutch, like \code{"Negatieve staven"}} #' } #' @source MOLIS (LIS of Certe) - \url{https://www.certe.nl} #' @seealso \code{\link{guess_bactid}} \code{\link{antibiotics}} \code{\link{microorganisms.umcg}} "microorganisms" #' Translation table for UMCG with ~1100 microorganisms #' #' A dataset containing all bacteria codes of UMCG MMB. These codes can be joined to data with an ID from \code{\link{microorganisms}$bactid} (using \code{\link{left_join_microorganisms}}). GLIMS codes can also be translated to valid \code{bactid}'s with \code{\link{guess_bactid}}. #' @format A data.frame with 1090 observations and 2 variables: #' \describe{ #' \item{\code{mocode}}{Code of microorganism according to UMCG MMB} #' \item{\code{bactid}}{Code of microorganism in \code{\link{microorganisms}}} #' } #' @source MOLIS (LIS of Certe) - \url{https://www.certe.nl} \cr \cr GLIMS (LIS of UMCG) - \url{https://www.umcg.nl} #' @seealso \code{\link{guess_bactid}} \code{\link{microorganisms}} "microorganisms.umcg" #' Dataset with 2000 blood culture isolates of septic patients #' #' An anonymised dataset containing 2000 microbial blood culture isolates with their antibiogram of septic patients found in 5 different hospitals in the Netherlands, between 2001 and 2017. This data.frame can be used to practice AMR analysis. For examples, press F1. #' @format A data.frame with 2000 observations and 47 variables: #' \describe{ #' \item{\code{date}}{date of receipt at the laboratory} #' \item{\code{hospital_id}}{ID of the hospital} #' \item{\code{ward_icu}}{logical to determine if ward is an intensive care unit} #' \item{\code{ward_clinical}}{logical to determine if ward is a regular clinical ward} #' \item{\code{ward_outpatient}}{logical to determine if ward is an outpatient clinic} #' \item{\code{age}}{age of the patient} #' \item{\code{sex}}{sex of the patient} #' \item{\code{patient_id}}{ID of the patient, first 10 characters of an SHA hash containing irretrievable information} #' \item{\code{bactid}}{ID of microorganism, see \code{\link{microorganisms}}} #' \item{\code{peni:mupi}}{38 different antibiotics with class \code{rsi} (see \code{\link{as.rsi}}); these column names occur in \code{\link{antibiotics}} and can be translated with \code{\link{abname}}} #' } #' @source MOLIS (LIS of Certe) - \url{https://www.certe.nl} #' @examples #' # ----------- # #' # PREPARATION # #' # ----------- # #' #' # Save this example dataset to an object, so we can edit it: #' my_data <- septic_patients #' #' # load the dplyr package to make data science A LOT easier #' library(dplyr) #' #' # Add first isolates to our dataset: #' my_data <- my_data %>% #' mutate(first_isolates = first_isolate(my_data, "date", "patient_id", "bactid")) #' #' # -------- # #' # ANALYSIS # #' # -------- # #' #' # 1. Get the amoxicillin resistance percentages #' # of E. coli, divided by hospital: #' #' my_data %>% #' filter(bactid == "ESCCOL", #' first_isolates == TRUE) %>% #' group_by(hospital_id) %>% #' summarise(n = n(), #' amoxicillin_resistance = rsi(amox)) #' #' #' # 2. Get the amoxicillin/clavulanic acid resistance #' # percentages of E. coli, trend over the years: #' #' my_data %>% #' filter(bactid == guess_bactid("E. coli"), #' first_isolates == TRUE) %>% #' group_by(year = format(date, "%Y")) %>% #' summarise(n = n(), #' amoxclav_resistance = rsi(amcl, minimum = 20)) "septic_patients"