The CCOS Communications Team interviewed researchers at the 2023 CTSA Fall Program Annual Meeting poster session in November as part of a series to feature ongoing projects across the CTSA hubs. In this article, we’re featuring Dr. Laurel Legenza, TL1/32 at University of Wisconsin Madison who presented her work on how antibiotic resistance varies at the neighborhood level.
Research Question
Although the threat of antimicrobial resistance (AMR) has been established globally, outcomes of AMR vary by region. This regional variation led Dr. Legenza and her team to explore whether geospatial analysis combined with data visualization methods could help detect both clinically and statistically significant variations in AMR rates at the neighborhood level in Wisconsin.
Research Plan
To assess AMR at the neighborhood level, patient-level antibiotic susceptibility data was collected from three regionally distinct Wisconsin health systems, with patient addresses geocoded to coordinates and joined with US Census Block Groups. Initial Escherichia coli (E. coli) isolates per patient per year per sample source with a patient address in Wisconsin were included. The researchers analyzed statistically significant local hot (high susceptibility) and cold spots (low susceptibility) for variations in antibiotic susceptibility by neighborhood.
Based on choropleth maps used to visualize spatial AMR data, hot and cold spots were identified at the neighborhood level in all three health systems. Hot spot analysis identified census blocks with statistically significantly higher and lower susceptibility. The study’s results also showed that AMR spatial clustering was observed in urban but not rural areas.
Next Steps
Along with a novel method for geographic analysis of AMR susceptibility data, the identification of AMR hot spots at the neighborhood level provides a foundation for future analyses and hypotheses. Dr. Legenza and her team feel that clinically meaningful differences in AMR could inform clinical guidelines and best practices and help translate this data to practice.
Reflection with the Researcher: What real-world benefits do you envision might come from work like this, and how would patients or community members benefit?
To Dr. Legenza’s knowledge, this is the first study to map AMR resistance at the neighborhood level. She is excited by this work because meaningful differences in AMR at this level could inform the development of a clinical decision support tool, which clinicians could use to ensure patients are getting the most effective antibiotic for their illness.
