# Antimicrobial Susceptibility Profiles of Escherichia coli Isolates from Clinical Cases of Ducks in Hungary Between 2022 and 2023

## TL;DR

This study found that most E. coli isolates from ducks in Hungary are multidrug-resistant, highlighting the need for better antibiotic use and predictive tools to manage resistance.

## Contribution

The study introduces machine learning models and Monte Carlo simulations to predict and analyze multidrug resistance in duck E. coli isolates.

## Key findings

- Monte Carlo simulations estimated an average MDR prevalence of 79.6% in E. coli isolates from ducks.
- Key predictors of MDR included enrofloxacin, neomycin, amoxicillin, and florfenicol.
- Strong cross-resistance was found between neomycin/spectinomycin and amoxicillin/doxycycline.

## Abstract

Background: Antimicrobial resistance (AMR) poses a growing threat to veterinary medicine and food safety. This study examines Escherichia coli antibiotic resistance patterns in ducks, focusing on multidrug-resistant (MDR) strains. Understanding resistance patterns and predicting MDR occurrence are critical for effective intervention strategies. Methods: E. coli isolates were collected from duck samples across multiple regions. Descriptive statistics and resistance frequency analyses were conducted. A decision tree classifier and a neural network were trained to predict MDR status. Cross-resistance relationships were visualized using graph-based models, and Monte Carlo simulations estimated MDR prevalence variations. Results: Monte Carlo simulations estimated an average MDR prevalence of 79.6% (95% CI: 73.1–86.1%). Key predictors in MDR classification models were enrofloxacin, neomycin, amoxicillin, and florfenicol. Strong cross-resistance associations were detected between neomycin and spectinomycin, as well as amoxicillin and doxycycline. Conclusions: The high prevalence of MDR strains underscores the urgent need to revise antibiotic usage guidelines in veterinary settings. The effectiveness of predictive models suggests that machine learning tools can aid in the early detection of MDR, contributing to the optimization of treatment strategies and the mitigation of resistance spread. The alarming MDR prevalence in E. coli isolates from ducks reinforces the importance of targeted surveillance and antimicrobial stewardship. Predictive models, including decision trees and neural networks, provide valuable insights into resistance trends, while Monte Carlo simulations further validate these findings, emphasizing the need for proactive antimicrobial management.