Open Access Highly Accessed Research article

The frequency of tetracycline resistance genes co-detected with respiratory pathogens: a database mining study uncovering descriptive trends throughout the United States

Matthew D Huff1*, David Weisman2, John Adams3, Song Li4, Jessica Green1, Leslie L Malone1 and Scott Clemmons1

Author Affiliations

1 Diatherix Laboratories Inc., 601 Genome Way, Suite 2100, Huntsville, Al 35806, USA

2 Department of Biology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125-3393, USA

3 Knoxville Infectious Disease Consultants, P.C., 2210 Sutherland Ave., Suite 110, Knoxville, TN 37919, USA

4 Hudson Alpha Institute of Biotechnology, 601 Genome Way, Huntsville, AL 35806, USA

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BMC Infectious Diseases 2014, 14:460  doi:10.1186/1471-2334-14-460

Published: 25 August 2014



The Center for Disease Control and Prevention (CDC) indicates that one of the largest problems threatening healthcare includes antibiotic resistance. Tetracycline, an effective antibiotic that has been in use for many years, is becoming less successful in treating certain pathogens. To better understand the temporal patterns in the growth of antibiotic resistance, patient diagnostic test records can be analyzed.


Data mining methods including frequent item set mining and association rules via the Apriori algorithm were used to analyze results from 80,241 Target Enriched Multiplex-PCR (TEM-PCR) reference laboratory tests. From the data mining results, five common respiratory pathogens and their co-detection rates with tetracycline resistance genes (TRG) were further analyzed and organized according to year, patient age, and geography.


From 2010, all five pathogens were associated with at least a 24% rise in co-detection rate for TRGs. Patients from 0–2 years old exhibited the lowest rate of TRG co-detection, while patients between 13–50 years old displayed the highest frequency of TRG co-detection. The Northeastern region of the United States recorded the highest rate of patients co-detected with a TRG and a respiratory pathogen. Along the East–west gradient, the relative frequency of co-detection between TRGs and respiratory pathogens decreased dramatically.


Significant trends were uncovered regarding the co-detection frequencies of TRGs and respiratory pathogens over time. It is valuable for the field of public health to monitor trends regarding the spread of resistant infectious disease, especially since tetracycline continues to be utilized a treatment for various microbial infections. Analyzing large datasets containing TEM-PCR results for co-detections provides valuable insights into trends of antibiotic resistance gene expression so that the effectiveness of first-line treatments can be continuously monitored.