### Last updated: 12 August 2022

#### New

• EUCAST 2022 and CLSI 2022 guidelines have been added for as.rsi(). EUCAST 2022 is now the new default guideline for all MIC and disks diffusion interpretations.

#### Changed

• Fix for as.rsi() on certain EUCAST breakpoints for MIC values
• Removed as.integer() for MIC values, since MIC are not integer values and running table() on MIC values consequently failed for not being able to retrieve the level position (as that’s how normally as.integer() on factors work)
• droplevels() on MIC will now return a common factor at default and will lose the <mic> class. Use droplevels(..., as.mic = TRUE) to keep the <mic> class.
• Small fix for using ab_from_text()
• Fixes for reading in text files using set_mo_source(), which now also allows the source file to contain valid taxonomic names instead of only valid microorganism ID of this package
• Using any random_*() function (such as random_mic()) is now possible by directly calling the package without loading it first: AMR::random_mic(10)
• Added Toxoplasma gondii (P_TXPL_GOND) to the microorganisms data set, together with its genus, family, and order
• Changed value in column prevalence of the microorganisms data set from 3 to 2 for these genera: Acholeplasma, Alistipes, Alloprevotella, Bergeyella, Borrelia, Brachyspira, Butyricimonas, Cetobacterium, Chlamydia, Chlamydophila, Deinococcus, Dysgonomonas, Elizabethkingia, Empedobacter, Haloarcula, Halobacterium, Halococcus, Myroides, Odoribacter, Ornithobacterium, Parabacteroides, Pedobacter, Phocaeicola, Porphyromonas, Riemerella, Sphingobacterium, Streptobacillus, Tenacibaculum, Terrimonas, Victivallis, Wautersiella, Weeksella

#### Changed

• Fix for using as.rsi() on values containing capped values (such as >=), sometimes leading to NA

• Support for antibiotic interpretations of the MIPS laboratory system: "U" for S (‘susceptible urine’), "D" for I (‘susceptible dose-dependent’)

• Improved algorithm of as.mo(), especially for ignoring non-taxonomic text, such as:


mo_name("methicillin-resistant S. aureus (MRSA)")
#> [1] "Staphylococcus aureus"

• Added 192 as valid MIC

• Updated MIC printing in tibbles

#### Other

• Fix for unit testing on R 3.3
• Fix for size of some image elements, as requested by CRAN

#### Breaking changes

• Removed p_symbol() and all filter_*() functions (except for filter_first_isolate()), which were all deprecated in a previous package version
• Removed the key_antibiotics() and key_antibiotics_equal() functions, which were deprecated and superseded by key_antimicrobials() and antimicrobials_equal()
• Removed all previously implemented ggplot2::ggplot() generics for classes <mic>, <disk>, <rsi> and <resistance_predict> as they did not follow the ggplot2 logic. They were replaced with ggplot2::autoplot() generics.
• Renamed function get_locale() to get_AMR_locale() to prevent conflicts with other packages

#### New

• Support for the CLSI 2021 guideline for interpreting MIC/disk diffusion values, which are incorporated in the rsi_translation data set. This data set now more strictly follows the WHONET software as well.

• Support for EUCAST Intrinsic Resistance and Unusual Phenotypes v3.3 (October 2021). This is now the default EUCAST guideline in the package (all older guidelines are still available) for eucast_rules(), mo_is_intrinsic_resistant() and mdro(). The intrinsic_resistant data set was also updated accordingly.

• Support for all antimicrobial drug (group) names and colloquial microorganism names in Danish, Dutch, English, French, German, Italian, Portuguese, Russian, Spanish and Swedish

• Function set_ab_names() to rename data set columns that resemble antimicrobial drugs. This allows for quickly renaming columns to official names, ATC codes, etc. Its second argument can be a tidyverse way of selecting:


example_isolates %>% set_ab_names(where(is.rsi))
example_isolates %>% set_ab_names(AMC:GEN, property = "atc")
• Function mo_lpsn() to retrieve the LPSN record ID

• Function ab_ddd_units() to get units of DDDs (daily defined doses), deprecating the use of ab_ddd(..., units = TRUE) to be more consistent in data types of function output

#### Changed

• Updated the bacterial taxonomy to 5 October 2021 (according to LPSN), including all 11 new staphylococcal species named since 1 January last year
• The antibiotics data set now contains all ATC codes that are available through the WHOCC website, regardless of drugs being present in more than one ATC group. This means that:
• Some drugs now contain multiple ATC codes (e.g., metronidazole contains 5)
• antibiotics$atc is now a list containing character vectors, and this atc column was moved to the 5th position of the antibiotics data set • ab_atc() does not always return a character vector of length 1, and returns a list if the input is larger than length 1 • ab_info() has a slightly different output • Some DDDs (daily defined doses) were added or updated according to newly included ATC codes • Antibiotic selectors • They now also work in R-3.0 and R-3.1, supporting every version of R since 2013 like the rest of the package • Added more selectors for antibiotic classes: aminopenicillins(), antifungals(), antimycobacterials(), lincosamides(), lipoglycopeptides(), polymyxins(), quinolones(), streptogramins(), trimethoprims() and ureidopenicillins() • Added specific selectors for certain types for treatment: administrable_per_os() and administrable_iv(), which are based on available Defined Daily Doses (DDDs), as defined by the WHOCC. These are ideal for e.g. analysing pathogens in primary care where IV treatment is not an option. They can be combined with other AB selectors, e.g. to select penicillins that are only administrable per os (i.e., orally):  example_isolates[, penicillins() & administrable_per_os()] # base R example_isolates %>% select(penicillins() & administrable_per_os()) # dplyr • Added the selector ab_selector(), which accepts a filter to be used internally on the antibiotics data set, yielding great flexibility on drug properties, such as selecting antibiotic columns with an oral DDD of at least 1 gram:  example_isolates[, ab_selector(oral_ddd > 1 & oral_units == "g")] # base R example_isolates %>% select(ab_selector(oral_ddd > 1 & oral_units == "g")) # dplyr • Added the selector not_intrinsic_resistant(), which only keeps antibiotic columns that are not intrinsic resistant for all microorganisms in a data set, based on the latest EUCAST guideline on intrinsic resistance. For example, if a data set contains only microorganism codes or names of E. coli and K. pneumoniae and contains a column “vancomycin”, this column will be removed (or rather, unselected) using this function. • Added argument only_treatable, which defaults to TRUE and will exclude drugs that are only for laboratory tests and not for treating patients (such as imipenem/EDTA and gentamicin-high) • Fix for using selectors multiple times in one call (e.g., using them in dplyr::filter() and immediately after in dplyr::select()) • Fix for using having multiple columns that are coerced to the same antibiotic agent • Fixed for using all() or any() on antibiotic selectors in an R Markdown file • Added the following antimicrobial agents that are now covered by the WHO: aztreonam/nacubactam (ANC), cefepime/nacubactam (FNC), exebacase (EXE), ozenoxacin (OZN), zoliflodacin (ZFD), manogepix (MGX), ibrexafungerp (IBX), and rezafungin (RZF). None of these agents have an ATC code yet. • Fixed the Gram stain (mo_gramstain()) determination of the taxonomic class Negativicutes within the phylum of Firmicutes - they were considered Gram-positives because of their phylum but are actually Gram-negative. This impacts 137 taxonomic species, genera and families, such as Negativicoccus and Veillonella. • Dramatic speed improvement for first_isolate() • Fix to prevent introducing NAs for old MO codes when running as.mo() on them • Added more informative error messages when any of the proportion_*() and count_*() functions fail • When printing a tibble with any old MO code, a warning will be thrown that old codes should be updated using as.mo() • Improved automatic column selector when col_* arguments are left blank, e.g. in first_isolate() • The right input types for random_mic(), random_disk() and random_rsi() are now enforced • as.rsi() has an improved algorithm and can now also correct for textual input (such as “Susceptible”, “Resistant”) in all supported languages • as.mic() has an improved algorithm • When warnings are thrown because of too few isolates in any count_*(), proportion_*() function (or resistant() or susceptible()), the dplyr group will be shown, if available • Fix for legends created with scale_rsi_colours() when using ggplot2 v3.3.4 or higher (this is ggplot2 bug 4511, soon to be fixed) • Fix for minor translation errors • Fix for the MIC interpretation of Morganellaceae (such as Morganella and Proteus) when using the EUCAST 2021 guideline • Improved algorithm of as.mo() • Improved algorithm for generating random MICs with random_mic() • Improved plot legends for MICs and disk diffusion values • Improved speed of as.ab() and all ab_*() functions • Added fortify() extensions for plotting methods • NA values of the classes <mic>, <disk> and <rsi> are now exported objects of this package, e.g. NA_mic_ is an NA of class mic (just like the base R NA_character_ is an NA of class character) • The proportion_df(), count_df() and rsi_df() functions now return with the additional S3 class ‘rsi_df’ so they can be extended by other packages • The mdro() function now returns NA for all rows that have no test results • The species_id column in the microorganisms data set now only contains LPSN record numbers. For this reason, this column is now numeric instead of a character, and mo_url() has been updated to reflect this change. • Fixed a small bug in the functions get_episode() and is_new_episode() • get_episode() and is_new_episode() can now cope with NAs #### Other • This package is now being maintained by two epidemiologists and a data scientist from two different non-profit healthcare organisations. #### Breaking change • All antibiotic class selectors (such as carbapenems(), aminoglycosides()) can now be used for filtering as well, making all their accompanying filter_*() functions redundant (such as filter_carbapenems(), filter_aminoglycosides()). These functions are now deprecated and will be removed in a next release. Examples of how the selectors can be used for filtering:  # select columns with results for carbapenems example_isolates[, carbapenems()] # base R example_isolates %>% select(carbapenems()) # dplyr # filter rows for resistance in any carbapenem example_isolates[any(carbapenems() == "R"), ] # base R example_isolates %>% filter(any(carbapenems() == "R")) # dplyr example_isolates %>% filter(if_any(carbapenems(), ~.x == "R")) # dplyr (formal) # filter rows for resistance in all carbapenems example_isolates[all(carbapenems() == "R"), ] # base R example_isolates[carbapenems() == "R", ] example_isolates %>% filter(all(carbapenems() == "R")) # dplyr example_isolates %>% filter(carbapenems() == "R") #### New • Support for CLSI 2020 guideline for interpreting MICs and disk diffusion values (using as.rsi()) • Function custom_eucast_rules() that brings support for custom AMR rules in eucast_rules() • Function italicise_taxonomy() to make taxonomic names within a string italic, with support for markdown and ANSI • Support for all four methods to determine first isolates as summarised by Hindler et al. (doi: 10.1086/511864): isolate-based, patient-based, episode-based and phenotype-based. The last method is now the default. • The first_isolate() function gained the argument method that has to be “phenotype-based”, “episode-based”, “patient-based”, or “isolate-based”. The old behaviour is equal to “episode-based”. The new default is “phenotype-based” if antimicrobial test results are available, and “episode-based” otherwise. This new default will yield slightly more isolates for selection (which is a good thing). • Since fungal isolates can also be selected, the functions key_antibiotics() and key_antibiotics_equal() are now deprecated in favour of the key_antimicrobials() and antimicrobials_equal() functions. Also, the new all_antimicrobials() function works like the old key_antibiotics() function, but includes any column with antimicrobial test results. Using key_antimicrobials() still only selects six preferred antibiotics for Gram-negatives, six for Gram-positives, and six universal antibiotics. It has a new antifungal argument to set antifungal agents (antimycotics). • Using type == "points" in the first_isolate() function for phenotype-based selection will now consider all antimicrobial drugs in the data set, using the new all_antimicrobials() • The first_isolate() function can now take a vector of values for col_keyantibiotics and can have an episode length of Inf • Since the phenotype-based method is the new default, filter_first_isolate() renders the filter_first_weighted_isolate() function redundant. For this reason, filter_first_weighted_isolate() is now deprecated. • The documentation of the first_isolate() and key_antimicrobials() functions has been completely rewritten. • Function betalactams() as additional antbiotic column selector and function filter_betalactams() as additional antbiotic column filter. The group of betalactams consists of all carbapenems, cephalosporins and penicillins. • A ggplot() method for resistance_predict() #### Changed • bug_drug_combinations() now supports grouping using the dplyr package • Custom MDRO guidelines (mdro(), custom_mdro_guideline()): • Custom MDRO guidelines can now be combined with other custom MDRO guidelines using c() • Fix for applying the rules; in previous versions, rows were interpreted according to the last matched rule. Now, rows are interpreted according to the first matched rule • Fix for age_groups() for persons aged zero • The example_isolates data set now contains some (fictitious) zero-year old patients • Fix for minor translation errors • Printing of microbial codes in a data.frame or tibble now gives a warning if the data contains old microbial codes (from a previous AMR package version) • Extended the like() functions: • Now checks if pattern is a valid regular expression • Added %unlike% and %unlike_case% (as negations of the existing %like% and %like_case%). This greatly improves readability:  if (!grepl("EUCAST", guideline)) ... # same: if (guideline %unlike% "EUCAST") ... • Altered the RStudio addin, so it now iterates over %like% -> %unlike% -> %like_case% -> %unlike_case% if you keep pressing your keyboard shortcut • Fixed an installation error on R-3.0 • Added info argument to as.mo() to turn on/off the progress bar • Fixed a bug where col_mo in some functions (esp. eucast_rules() and mdro()) could not be a column name of the microorganisms data set as it would throw an error • Fix for transforming numeric values to RSI (as.rsi()) when the vctrs package is loaded (i.e., when using tidyverse) • Colour fix for using barplot() on an RSI class • Added 25 common system codes for bacteria to the microorganisms.codes data set • Added 16 common system codes for antimicrobial agents to the antibiotics data set • Fix for using skimr::skim() on classes mo, mic and disk when using the just released dplyr v1.0.6 • Updated skimr::skim() usage for MIC values to also include 25th and 75th percentiles • Fix for plotting missing MIC/disk diffusion values • Updated join functions to always use dplyr join functions if the dplyr package is installed - now also preserving grouped variables • Antibiotic class selectors (such as cephalosporins()) now maintain the column order from the original data • Fix for selecting columns using fluoroquinolones() • age() now vectorises over both x and reference #### Other • As requested by CRAN administrators: decreased package size by 3 MB in costs of a slower loading time of the package • All unit tests are now processed by the tinytest package, instead of the testthat package. The testthat package unfortunately requires tons of dependencies that are also heavy and only usable for recent R versions, disallowing developers to test a package under any R 3.* version. On the contrary, the tinytest package is very lightweight and dependency-free. #### New • Support for EUCAST Clinical Breakpoints v11.0 (2021), effective in the eucast_rules() function and in as.rsi() to interpret MIC and disk diffusion values. This is now the default guideline in this package. • Added function eucast_dosage() to get a data.frame with advised dosages of a certain bug-drug combination, which is based on the new dosage data set • Added data set dosage to fuel the new eucast_dosage() function and to make this data available in a structured way • Existing data set example_isolates now reflects the latest EUCAST rules • Added argument only_rsi_columns for some functions, which defaults to FALSE, to indicate if the functions must only be applied to columns that are of class <rsi> (i.e., transformed with as.rsi()). This increases speed since automatic determination of antibiotic columns is not needed anymore. Affected functions are: • All antibiotic selector functions (ab_class() and its wrappers, such as aminoglycosides(), carbapenems(), penicillins()) • All antibiotic filter functions (filter_ab_class() and its wrappers, such as filter_aminoglycosides(), filter_carbapenems(), filter_penicillins()) • eucast_rules() • mdro() (including wrappers such as brmo(), mrgn() and eucast_exceptional_phenotypes()) • guess_ab_col() • Functions oxazolidinones() (an antibiotic selector function) and filter_oxazolidinones() (an antibiotic filter function) to select/filter on e.g. linezolid and tedizolid  library(dplyr) x <- example_isolates %>% select(date, hospital_id, oxazolidinones()) #> Selecting oxazolidinones: column 'LNZ' (linezolid) x <- example_isolates %>% filter_oxazolidinones() #> Filtering on oxazolidinones: value in column LNZ (linezolid) is either "R", "S" or "I" • Support for custom MDRO guidelines, using the new custom_mdro_guideline() function, please see mdro() for additional info • ggplot() generics for classes <mic> and <disk> • Function mo_is_yeast(), which determines whether a microorganism is a member of the taxonomic class Saccharomycetes or the taxonomic order Saccharomycetales:  mo_kingdom(c("Aspergillus", "Candida")) #> [1] "Fungi" "Fungi" mo_is_yeast(c("Aspergillus", "Candida")) #> [1] FALSE TRUE # usage for filtering data: example_isolates[which(mo_is_yeast()), ] # base R example_isolates %>% filter(mo_is_yeast()) # dplyr The mo_type() function has also been updated to reflect this change:  mo_type(c("Aspergillus", "Candida")) # [1] "Fungi" "Yeasts" mo_type(c("Aspergillus", "Candida"), language = "es") # also supported: de, nl, fr, it, pt #> [1] "Hongos" "Levaduras" • Added Pretomanid (PMD, J04AK08) to the antibiotics data set • MIC values (see as.mic()) can now be used in any mathematical processing, such as usage inside functions min(), max(), range(), and with binary operators (+, -, etc.). This allows for easy distribution analysis and fast filtering on MIC values:  x <- random_mic(10) x #> Class <mic> #> [1] 128 0.5 2 0.125 64 0.25 >=256 8 16 4 x[x > 4] #> Class <mic> #> [1] 128 64 >=256 8 16 range(x) #> [1] 0.125 256.000 range(log2(x)) #> [1] -3 8 #### Changed • Updated the bacterial taxonomy to 3 March 2021 (using LPSN) • Added 3,372 new species and 1,523 existing species became synomyms • The URL of a bacterial species (mo_url()) will now lead to https://lpsn.dsmz.de • Big update for plotting classes rsi, <mic>, and <disk>: • Plotting of MIC and disk diffusion values now support interpretation colouring if you supply the microorganism and antimicrobial agent • All colours were updated to colour-blind friendly versions for values R, S and I for all plot methods (also applies to tibble printing) • Interpretation of MIC and disk diffusion values to R/SI will now be translated if the system language is German, Dutch or Spanish (see translate) • Plotting is now possible with base R using plot() and with ggplot2 using ggplot() on any vector of MIC and disk diffusion values • Updated SNOMED codes to US Edition of SNOMED CT from 1 September 2020 and added the source to the help page of the microorganisms data set • is.rsi() and is.rsi.eligible() now return a vector of TRUE/FALSE when the input is a data set, by iterating over all columns • Using functions without setting a data set (e.g., mo_is_gram_negative(), mo_is_gram_positive(), mo_is_intrinsic_resistant(), first_isolate(), mdro()) now work with dplyrs group_by() again • first_isolate() can be used with group_by() (also when using a dot . as input for the data) and now returns the names of the groups • Updated the data set microorganisms.codes (which contains popular LIS and WHONET codes for microorganisms) for some species of Mycobacterium that previously incorrectly returned M. africanum • WHONET code "PNV" will now correctly be interpreted as PHN, the antibiotic code for phenoxymethylpenicillin (‘peni V’) • Fix for verbose output of mdro(..., verbose = TRUE) for German guideline (3MGRN and 4MGRN) and Dutch guideline (BRMO, only P. aeruginosa) • is.rsi.eligible() now detects if the column name resembles an antibiotic name or code and now returns TRUE immediately if the input contains any of the values “R”, “S” or “I”. This drastically improves speed, also for a lot of other functions that rely on automatic determination of antibiotic columns. • Functions get_episode() and is_new_episode() now support less than a day as value for argument episode_days (e.g., to include one patient/test per hour) • Argument ampc_cephalosporin_resistance in eucast_rules() now also applies to value “I” (not only “S”) • Functions print() and summary() on a Principal Components Analysis object (pca()) now print additional group info if the original data was grouped using dplyr::group_by() • Improved speed and reliability of guess_ab_col(). As this also internally improves the reliability of first_isolate() and mdro(), this might have a slight impact on the results of those functions. • Fix for mo_name() when used in other languages than English • The like() function (and its fast alias %like%) now always use Perl compatibility, improving speed for many functions in this package (e.g., as.mo() is now up to 4 times faster) • Staphylococcus cornubiensis is now correctly categorised as coagulase-positive • random_disk() and random_mic() now have an expanded range in their randomisation • Support for GISA (glycopeptide-intermediate S. aureus), so e.g. mo_genus("GISA") will return "Staphylococcus" • Added translations of German and Spanish for more than 200 antimicrobial drugs • Speed improvement for as.ab() when the input is an official name or ATC code • Added argument include_untested_rsi to the first_isolate() functions (defaults to TRUE to keep existing behaviour), to be able to exclude rows where all R/SI values (class <rsi>, see as.rsi()) are empty #### Other • Big documentation updates • Loading the package (i.e., library(AMR)) now is ~50 times faster than before, in costs of package size (which increased by ~3 MB) #### New • Functions get_episode() and is_new_episode() to determine (patient) episodes which are not necessarily based on microorganisms. The get_episode() function returns the index number of the episode per group, while the is_new_episode() function returns values TRUE/FALSE to indicate whether an item in a vector is the start of a new episode. They also support dplyrs grouping (i.e. using group_by()):  library(dplyr) example_isolates %>% group_by(patient_id, hospital_id) %>% filter(is_new_episode(date, episode_days = 60)) • Functions mo_is_gram_negative() and mo_is_gram_positive() as wrappers around mo_gramstain(). They always return TRUE or FALSE (except when the input is NA or the MO code is UNKNOWN), thus always return FALSE for species outside the taxonomic kingdom of Bacteria. • Function mo_is_intrinsic_resistant() to test for intrinsic resistance, based on EUCAST Intrinsic Resistance and Unusual Phenotypes v3.2 from 2020. • Functions random_mic(), random_disk() and random_rsi() for random value generation. The functions random_mic() and random_disk() take microorganism names and antibiotic names as input to make generation more realistic. #### Changed • New argument ampc_cephalosporin_resistance in eucast_rules() to correct for AmpC de-repressed cephalosporin-resistant mutants • Interpretation of antimicrobial resistance - as.rsi(): • Reference data used for as.rsi() can now be set by the user, using the reference_data argument. This allows for using own interpretation guidelines. The user-set data must have the same structure as rsi_translation. • Better determination of disk zones and MIC values when running as.rsi() on a data.frame • Fix for using as.rsi() on a data.frame in older R versions • as.rsi() on a data.frame will not print a message anymore if the values are already clean R/SI values • If using as.rsi() on MICs or disk diffusion while there is intrinsic antimicrobial resistance, a warning will be thrown to remind about this • Fix for using as.rsi() on a data.frame that only contains one column for antibiotic interpretations • Some functions are now context-aware when used inside dplyr verbs, such as filter(), mutate() and summarise(). This means that then the data argument does not need to be set anymore. This is the case for the new functions: • mo_is_gram_negative() • mo_is_gram_positive() • mo_is_intrinsic_resistant() … and for the existing functions: • first_isolate(), • key_antibiotics(), • mdro(), • brmo(), • mrgn(), • mdr_tb(), • mdr_cmi2012(), • eucast_exceptional_phenotypes()  # to select first isolates that are Gram-negative # and view results of cephalosporins and aminoglycosides: library(dplyr) example_isolates %>% filter(first_isolate(), mo_is_gram_negative()) %>% select(mo, cephalosporins(), aminoglycosides()) %>% as_tibble() • For antibiotic selection functions (such as cephalosporins(), aminoglycosides()) to select columns based on a certain antibiotic group, the dependency on the tidyselect package was removed, meaning that they can now also be used without the need to have this package installed and now also work in base R function calls (they rely on R 3.2 or later):  # above example in base R: example_isolates[which(first_isolate() & mo_is_gram_negative()), c("mo", cephalosporins(), aminoglycosides())] • For all function arguments in the code, it is now defined what the exact type of user input should be (inspired by the typed package). If the user input for a certain function does not meet the requirements for a specific argument (such as the class or length), an informative error will be thrown. This makes the package more robust and the use of it more reproducible and reliable. In total, more than 420 arguments were defined. • Fix for set_mo_source(), that previously would not remember the file location of the original file • Deprecated function p_symbol() that not really fits the scope of this package. It will be removed in a future version. See here for the source code to preserve it. • Updated coagulase-negative staphylococci determination with Becker et al. 2020 (PMID 32056452), meaning that the species S. argensis, S. caeli, S. debuckii, S. edaphicus and S. pseudoxylosus are now all considered CoNS • Fix for using argument reference_df in as.mo() and mo_*() functions that contain old microbial codes (from previous package versions) • Fixed a bug where mo_uncertainties() would not return the results based on the MO matching score • Fixed a bug where as.mo() would not return results for known laboratory codes for microorganisms • Fixed a bug where as.ab() would sometimes fail • Better tibble printing for MIC values • Fix for plotting MIC values with plot() • Added plot() generic to class <disk> • LA-MRSA and CA-MRSA are now recognised as an abbreviation for Staphylococcus aureus, meaning that e.g. mo_genus("LA-MRSA") will return "Staphylococcus" and mo_is_gram_positive("LA-MRSA") will return TRUE. • Fix for printing class in tibbles when all values are NA • Fix for mo_shortname() when the input contains NA • If as.mo() takes more than 30 seconds, some suggestions will be done to improve speed #### Other • All messages and warnings thrown by this package now break sentences on whole words • More extensive unit tests • Internal calls to options() were all removed in favour of a new internal environment pkg_env • Improved internal type setting (among other things: replaced all sapply() calls with vapply()) • Added CodeFactor as a continuous code review to this package: https://www.codefactor.io/repository/github/msberends/amr/ • Added Dr. Rogier Schade as contributor #### New • Support for ‘EUCAST Expert Rules’ / ‘EUCAST Intrinsic Resistance and Unusual Phenotypes’ version 3.2 of May 2020. With this addition to the previously implemented version 3.1 of 2016, the eucast_rules() function can now correct for more than 180 different antibiotics and the mdro() function can determine multidrug resistance based on more than 150 different antibiotics. All previously implemented versions of the EUCAST rules are now maintained and kept available in this package. The eucast_rules() function consequently gained the arguments version_breakpoints (at the moment defaults to v10.0, 2020) and version_expertrules (at the moment defaults to v3.2, 2020). The example_isolates data set now also reflects the change from v3.1 to v3.2. The mdro() function now accepts guideline == "EUCAST3.1" and guideline == "EUCAST3.2". • A new vignette and website page with info about all our public and freely available data sets, that can be downloaded as flat files or in formats for use in R, SPSS, SAS, Stata and Excel: https://msberends.github.io/AMR/articles/datasets.html • Data set intrinsic_resistant. This data set contains all bug-drug combinations where the ‘bug’ is intrinsic resistant to the ‘drug’ according to the latest EUCAST insights. It contains just two columns: microorganism and antibiotic. Curious about which enterococci are actually intrinsic resistant to vancomycin?  library(AMR) library(dplyr) intrinsic_resistant %>% filter(antibiotic == "Vancomycin", microorganism %like% "Enterococcus") %>% pull(microorganism) #> [1] "Enterococcus casseliflavus" "Enterococcus gallinarum"  • Support for veterinary ATC codes • Support for skimming classes <rsi>, <mic>, <disk> and <mo> with the skimr package #### Changed • Although advertised that this package should work under R 3.0.0, we still had a dependency on R 3.6.0. This is fixed, meaning that our package should now work under R 3.0.0. • Improvements for as.rsi(): • Support for using dplyr’s across() to interpret MIC values or disk zone diameters, which also automatically determines the column with microorganism names or codes.  # until dplyr 1.0.0 your_data %>% mutate_if(is.mic, as.rsi) your_data %>% mutate_if(is.disk, as.rsi) # since dplyr 1.0.0 your_data %>% mutate(across(where(is.mic), as.rsi)) your_data %>% mutate(across(where(is.disk), as.rsi)) • Cleaning columns in a data.frame now allows you to specify those columns with tidy selection, e.g. as.rsi(df, col1:col9) • Big speed improvement for interpreting MIC values and disk zone diameters. When interpreting 5,000 MIC values of two antibiotics (10,000 values in total), our benchmarks showed a total run time going from 80.7-85.1 seconds to 1.8-2.0 seconds. • Added argument ‘add_intrinsic_resistance’ (defaults to FALSE), that considers intrinsic resistance according to EUCAST • Fixed a bug where in EUCAST rules the breakpoint for R would be interpreted as “>=” while this should have been “<” • Added intelligent data cleaning to as.disk(), so numbers can also be extracted from text and decimal numbers will always be rounded up:  as.disk(c("disk zone: 23.4 mm", 23.4)) #> Class <disk> #> [1] 24 24 • Improvements for as.mo(): • A completely new matching score for ambiguous user input, using mo_matching_score(). Any user input value that could mean more than one taxonomic entry is now considered ‘uncertain’. Instead of a warning, a message will be thrown and the accompanying mo_uncertainties() has been changed completely; it now prints all possible candidates with their matching score. • Big speed improvement for already valid microorganism ID. This also means an significant speed improvement for using mo_* functions like mo_name() on microoganism IDs. • Added argument ignore_pattern to as.mo() which can also be given to mo_* functions like mo_name(), to exclude known non-relevant input from analysing. This can also be set with the option AMR_ignore_pattern. • get_locale() now uses at default Sys.getenv("LANG") or, if LANG is not set, Sys.getlocale(). This can be overwritten by setting the option AMR_locale. • Big speed improvement for eucast_rules() • Overall speed improvement by tweaking joining functions • Function mo_shortname() now returns the genus for input where the species is unknown • BORSA is now recognised as an abbreviation for Staphylococcus aureus, meaning that e.g. mo_genus("BORSA") will return “Staphylococcus” • Added a feature from AMR 1.1.0 and earlier again, but now without other package dependencies: tibble printing support for classes <rsi>, <mic>, <disk>, <ab> and <mo>. When using tibbles containing antimicrobial columns (class <rsi>), “S” will print in green, “I” will print in yellow and “R” will print in red. Microbial IDs (class <mo>) will emphasise on the genus and species, not on the kingdom. • Names of antiviral agents in data set antivirals now have a starting capital letter, like it is the case in the antibiotics data set • Updated the documentation of the WHONET data set to clarify that all patient names are fictitious • Small as.ab() algorithm improvements • Fix for combining MIC values with raw numbers, i.e. c(as.mic(2), 2) previously failed but now returns a valid MIC class • ggplot_rsi() and geom_rsi() gained arguments minimum and language, to influence the internal use of rsi_df() • Changes in the antibiotics data set: • Updated oral and parental DDDs from the WHOCC • Added abbreviation “piptazo” to ‘Piperacillin/tazobactam’ (TZP) • ‘Penicillin G’ (for intravenous use) is now named ‘Benzylpenicillin’ (code PEN) • ‘Penicillin V’ (for oral use, code PNV) was removed, since its actual entry ‘Phenoxymethylpenicillin’ (code PHN) already existed • The group name (antibiotics$group) of ‘Linezolid’ (LNZ), ‘Cycloserine’ (CYC), ‘Tedizolid’ (TZD) and ‘Thiacetazone’ (THA) is now “Oxazolidinones” instead of “Other antibacterials”
• Added support for using unique() on classes <rsi>, <mic>, <disk>, <ab> and <mo>

• Added argument excess to the kurtosis() function (defaults to FALSE), to return the excess kurtosis, defined as the kurtosis minus three.

#### Other

• Removed functions portion_R(), portion_S() and portion_I() that were deprecated since version 0.9.0 (November 2019) and were replaced with proportion_R(), proportion_S() and proportion_I()
• Removed unnecessary references to the base package
• Added packages that could be useful for some functions to the Suggests field of the DESCRIPTION file

#### New

• Function ab_from_text() to retrieve antimicrobial drug names, doses and forms of administration from clinical texts in e.g. health care records, which also corrects for misspelling since it uses as.ab() internally

• Tidyverse selection helpers for antibiotic classes, that help to select the columns of antibiotics that are of a specific antibiotic class, without the need to define the columns or antibiotic abbreviations. They can be used in any function that allows selection helpers, like dplyr::select() and tidyr::pivot_longer():


library(dplyr)

# Columns 'IPM' and 'MEM' are in the example_isolates data set
example_isolates %>%
select(carbapenems())
#> Selecting carbapenems: IPM (imipenem), MEM (meropenem)
• Added mo_domain() as an alias to mo_kingdom()

• Added function filter_penicillins() to filter isolates on a specific result in any column with a name in the antimicrobial ‘penicillins’ class (more specific: ATC subgroup Beta-lactam antibacterials, penicillins)

• Added official antimicrobial names to all filter_ab_class() functions, such as filter_aminoglycosides()

• Added antibiotics code “FOX1” for cefoxitin screening (abbreviation “cfsc”) to the antibiotics data set

• Added argument conserve_capped_values to as.rsi() for interpreting MIC values - it makes sure that values starting with “<” (but not “<=”) will always return “S” and values starting with “>” (but not “>=”) will always return “R”. The default behaviour of as.rsi() has not changed, so you need to specifically do as.rsi(..., conserve_capped_values = TRUE).

#### Changed

• Big speed improvement for using any function on microorganism codes from earlier package versions (prior to AMR v1.2.0), such as as.mo(), mo_name(), first_isolate(), eucast_rules(), mdro(), etc.

As a consequence, very old microbial codes (from AMR v0.5.0 and lower) are not supported anymore. Use as.mo() on your microorganism names or codes to transform them to current abbreviations used in this package.

• Improvements for susceptibility() and resistance() and all count_*(), proportion_*() functions:

• 95% speed improvement by using other base R functions for calculation
• Using unexisting columns wil now return an error instead of dropping them silently
• Using variables for column names (as well as selectors like dplyr::all_of()) now works again
• Improvements for as.ab():

• Dramatic improvement of the algorithm behind as.ab(), making many more input errors translatable, such as digitalised health care records, using too few or too many vowels or consonants and many more
• Fixed a bug where as.ab() would return an error on invalid input values
• The as.ab() function will now throw a note if more than 1 antimicrobial drug could be retrieved from a single input value.
• Fixed a bug where eucast_rules() would not work on a tibble when the tibble or dplyr package was loaded

• Fixed a bug for CLSI 2019 guidelines (using as.rsi()), that also included results for animals. It now only contains interpretation guidelines for humans.

• All *_join_microorganisms() functions and bug_drug_combinations() now return the original data class (e.g. tibbles and data.tables)

• For functions rsi_df(), proportion_df() and count_df():

• Fixed a bug for using grouped versions
• Fixed a bug where not all different antimicrobial results were added as rows
• Fixed a bug when only calculating counts (count_df()) when all antibiotics in the data set have only NAs
• Improved auto-determination for columns of types <mo> and <Date>

• Fixed a bug in bug_drug_combinations() for when only one antibiotic was in the input data

• Changed the summary for class <rsi>, to highlight the %SI vs. %R

• Improved error handling, giving more useful info when functions return an error

• Any progress bar will now only show in interactive mode (i.e. not in R Markdown)

• Speed improvement for mdro() and filter_ab_class()

• New option arrows_textangled for ggplot_pca() to indicate whether the text at the end of the arrows should be angled (defaults to TRUE, as it was in previous versions)

• Added parenteral DDD to benzylpenicillin

• Fixed a bug where as.mic() could not handle dots without a leading zero (like "<=.25)

#### Other

• Moved primary location of this project from GitLab to GitHub, giving us native support for automated syntax checking without being dependent on external services such as AppVeyor and Travis CI.

#### Breaking

• Removed code dependency on all other R packages, making this package fully independent of the development process of others. This is a major code change, but will probably not be noticeable by most users.

Making this package independent of especially the tidyverse (e.g. packages dplyr and tidyr) tremendously increases sustainability on the long term, since tidyverse functions change quite often. Good for users, but hard for package maintainers. Most of our functions are replaced with versions that only rely on base R, which keeps this package fully functional for many years to come, without requiring a lot of maintenance to keep up with other packages anymore. Another upside it that this package can now be used with all versions of R since R-3.0.0 (April 2013). Our package is being used in settings where the resources are very limited. Fewer dependencies on newer software is helpful for such settings.

Negative effects of this change are:

• Function freq() that was borrowed from the cleaner package was removed. Use cleaner::freq(), or run library("cleaner") before you use freq().
• Printing values of class mo or rsi in a tibble will no longer be in colour and printing rsi in a tibble will show the class <ord>, not <rsi> anymore. This is purely a visual effect.
• All functions from the mo_* family (like mo_name() and mo_gramstain()) are noticeably slower when running on hundreds of thousands of rows.
• For developers: classes mo and ab now both also inherit class character, to support any data transformation. This change invalidates code that checks for class length == 1.

#### Changed

• Taxonomy:
• Updated the taxonomy of microorganisms to May 2020, using the Catalogue of Life (CoL), the Global Biodiversity Information Facility (GBIF) and the List of Prokaryotic names with Standing in Nomenclature (LPSN, hosted by DSMZ since February 2020). Note: a taxonomic update may always impact determination of first isolates (using first_isolate()), since some bacterial names might be renamed to other genera or other (sub)species. This is expected behaviour.
• Removed the Catalogue of Life IDs (like 776351), since they now work with a species ID (hexadecimal string)
• EUCAST rules:
• The eucast_rules() function no longer applies “other” rules at default that are made available by this package (like setting ampicillin = R when ampicillin + enzyme inhibitor = R). The default input value for rules is now c("breakpoints", "expert") instead of "all", but this can be changed by the user. To return to the old behaviour, set options(AMR.eucast_rules = "all").
• Fixed a bug where checking antimicrobial results in the original data were not regarded as valid R/SI values
• All “other” rules now apply for all drug combinations in the antibiotics data set these two rules:
1. A drug with enzyme inhibitor will be set to S if the drug without enzyme inhibitor is S
2. A drug without enzyme inhibitor will be set to R if the drug with enzyme inhibitor is R
This works for all drug combinations, such as ampicillin/sulbactam, ceftazidime/avibactam, trimethoprim/sulfamethoxazole, etc.
• Added official drug names to verbose output of eucast_rules()
• Added function ab_url() to return the direct URL of an antimicrobial agent from the official WHO website
• Improvements for algorithm in as.ab(), so that e.g. as.ab("ampi sul") and ab_name("ampi sul") work
• Functions ab_atc() and ab_group() now return NA if no antimicrobial agent could be found
• Small fix for some text input that could not be coerced as valid MIC values
• Fix for interpretation of generic CLSI interpretation rules (thanks to Anthony Underwood)
• Fix for set_mo_source() to make sure that column mo will always be the second column
• Added abbreviation “cfsc” for Cefoxitin and “cfav” for Ceftazidime/avibactam

#### Other

• Removed previously deprecated function p.symbol() - it was replaced with p_symbol()
• Removed function read.4d(), that was only useful for reading data from an old test database.

#### New

• Support for easy principal component analysis for AMR, using the new pca() function
• Plotting biplots for principal component analysis using the new ggplot_pca() function

#### Changed

• Improvements for the algorithm used by as.mo() (and consequently all mo_* functions, that use as.mo() internally):
• Support for codes ending with SPE for species, like "ESCSPE" for Escherichia coli
• Support for any encoding, which means that any language-specific character with accents can be used for input
• Support for more arbitrary IDs used in laboratory information systems
• Small fix for preventing viruses being treated as bacteria
• Small fix for preventing contamination and lack of growth being treated as valid microorganisms
• Support for all abbreviations of antibiotics and antimycotics used by the Netherlands National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu; RIVM)
• Added more abbreviations to the antibiotics data set
• Reloaded original EUCAST master tables from 2019 (2020 was already available). This seems more reliable than the data we used from WHONET.
• Added generic CLSI rules for R/SI interpretation using as.rsi() for years 2010-2019 (thanks to Anthony Underwood)

#### Other

• Support for the upcoming dplyr version 1.0.0
• More robust assigning for classes rsi and mic

#### Changed

• Fixed important floating point error for some MIC comparisons in EUCAST 2020 guideline

• Interpretation from MIC values (and disk zones) to R/SI can now be used with mutate_at() of the dplyr package:


yourdata %>%
mutate_at(vars(antibiotic1:antibiotic25), as.rsi, mo = "E. coli")

yourdata %>%
mutate_at(vars(antibiotic1:antibiotic25), as.rsi, mo = .$mybacteria) • Added antibiotic abbreviations for a laboratory manufacturer (GLIMS) for cefuroxime, cefotaxime, ceftazidime, cefepime, cefoxitin and trimethoprim/sulfamethoxazole • Added uti (as abbreviation of urinary tract infections) as argument to as.rsi(), so interpretation of MIC values and disk zones can be made dependent on isolates specifically from UTIs • Info printing in functions eucast_rules(), first_isolate(), mdro() and resistance_predict() will now at default only print when R is in an interactive mode (i.e. not in RMarkdown) This software is now out of beta and considered stable. Nonetheless, this package will be developed continually. #### New • Support for the newest EUCAST Clinical Breakpoint Tables v.10.0, valid from 1 January 2020. This affects translation of MIC and disk zones using as.rsi() and inferred resistance and susceptibility using eucast_rules(). • The repository of this package now contains a clean version of the EUCAST and CLSI guidelines from 2011-2020 to translate MIC and disk diffusion values to R/SI: https://github.com/msberends/AMR/blob/main/data-raw/rsi_translation.txt. This allows for machine reading these guidelines, which is almost impossible with the Excel and PDF files distributed by EUCAST and CLSI. This file used to process the EUCAST Clinical Breakpoints Excel file can be found here. • Support for LOINC and SNOMED codes • Support for LOINC codes in the antibiotics data set. Use ab_loinc() to retrieve LOINC codes, or use a LOINC code for input in any ab_* function:  ab_loinc("ampicillin") #> [1] "21066-6" "3355-5" "33562-0" "33919-2" "43883-8" "43884-6" "87604-5" ab_name("21066-6") #> [1] "Ampicillin" ab_atc("21066-6") #> [1] "J01CA01" • Support for SNOMED CT codes in the microorganisms data set. Use mo_snomed() to retrieve SNOMED codes, or use a SNOMED code for input in any mo_* function:  mo_snomed("S. aureus") #> [1] 115329001 3092008 113961008 mo_name(115329001) #> [1] "Staphylococcus aureus" mo_gramstain(115329001) #> [1] "Gram-positive" #### Changes • The as.mo() function previously wrote to the package folder to improve calculation speed for previously calculated results. This is no longer the case, to comply with CRAN policies. Consequently, the function clear_mo_history() was removed. • Bugfix for some WHONET microorganism codes that were not interpreted correctly when using as.rsi() • Improvements for the algorithm used by as.mo() (and consequently all mo_* functions, that use as.mo() internally): • Support for missing spaces, e.g. in as.mo("Methicillin-resistant S.aureus") • Better support for determination of Salmonella biovars • Speed improvements, especially for the G. species format (G for genus), like E. coli and K pneumoniae • Support for more common codes used in laboratory information systems • Input values for as.disk() limited to a maximum of 50 millimeters • Added a lifecycle state to every function, following the lifecycle circle of the tidyverse • For in as.ab(): support for drugs starting with “co-” like co-amoxiclav, co-trimoxazole, co-trimazine and co-trimazole (thanks to Peter Dutey) • Changes to the antibiotics data set (thanks to Peter Dutey): • Added more synonyms to colistin, imipenem and piperacillin/tazobactam • Moved synonyms Rifinah and Rimactazid from rifampicin (RIF) to rifampicin/isoniazid (RFI). Please note that the combination rifampicin/isoniazid has no DDDs defined, so e.g. ab_ddd("Rimactazid") will now return NA. • Moved synonyms Bactrimel and Cotrimazole from sulfamethoxazole (SMX) to trimethoprim/sulfamethoxazole (SXT) #### Other • Add a CITATION file • Full support for the upcoming R 4.0 • Removed unnecessary AMR:: calls #### Breaking • Adopted Adeolu et al. (2016), PMID 27620848 for the microorganisms data set, which means that the new order Enterobacterales now consists of a part of the existing family Enterobacteriaceae, but that this family has been split into other families as well (like Morganellaceae and Yersiniaceae). Although published in 2016, this information is not yet in the Catalogue of Life version of 2019. All MDRO determinations with mdro() will now use the Enterobacterales order for all guidelines before 2016 that were dependent on the Enterobacteriaceae family. • If you were dependent on the old Enterobacteriaceae family e.g. by using in your code:  if (mo_family(somebugs) == "Enterobacteriaceae") ... then please adjust this to:  if (mo_order(somebugs) == "Enterobacterales") ... #### New • Functions susceptibility() and resistance() as aliases of proportion_SI() and proportion_R(), respectively. These functions were added to make it more clear that “I” should be considered susceptible and not resistant.  library(dplyr) example_isolates %>% group_by(bug = mo_name(mo)) %>% summarise(amoxicillin = resistance(AMX), amox_clav = resistance(AMC)) %>% filter(!is.na(amoxicillin) | !is.na(amox_clav)) • Support for a new MDRO guideline: Magiorakos AP, Srinivasan A et al. “Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance.” Clinical Microbiology and Infection (2012). • This is now the new default guideline for the mdro() function • The new Verbose mode (mdro(...., verbose = TRUE)) returns an informative data set where the reason for MDRO determination is given for every isolate, and an list of the resistant antimicrobial agents • Data set antivirals, containing all entries from the ATC J05 group with their DDDs for oral and parenteral treatment #### Changes • Improvements to algorithm in as.mo(): • Now allows “ou” where “au” should have been used and vice versa • More intelligent way of coping with some consonants like “l” and “r” • Added a score (a certainty percentage) to mo_uncertainties(), that is calculated using the Levenshtein distance:  as.mo(c("Stafylococcus aureus", "staphylokok aureuz")) #> Warning: #> Results of two values were guessed with uncertainty. Use mo_uncertainties() to review them. #> Class 'mo' #> [1] B_STPHY_AURS B_STPHY_AURS mo_uncertainties() #> "Stafylococcus aureus" -> Staphylococcus aureus (B_STPHY_AURS, score: 95.2%) #> "staphylokok aureuz" -> Staphylococcus aureus (B_STPHY_AURS, score: 85.7%) • Removed previously deprecated function as.atc() - this function was replaced by ab_atc() • Renamed all portion_* functions to proportion_*. All portion_* functions are still available as deprecated functions, and will return a warning when used. • When running as.rsi() over a data set, it will now print the guideline that will be used if it is not specified by the user • Improvements for eucast_rules(): • Fix where Stenotrophomonas maltophilia would always become ceftazidime R (following EUCAST v3.1) • Fix where Leuconostoc and Pediococcus would not always become glycopeptides R • non-EUCAST rules in eucast_rules() are now applied first and not as last anymore. This is to improve the dependency on certain antibiotics for the official EUCAST rules. Please see ?eucast_rules. • Fix for interpreting MIC values with as.rsi() where the input is NA • Added “imi” and “imp” as allowed abbreviation for Imipenem (IPM) • Fix for automatically determining columns with antibiotic results in mdro() and eucast_rules() • Added ATC codes for ceftaroline, ceftobiprole and faropenem and fixed two typos in the antibiotics data set • More robust way of determining valid MIC values • Small changed to the example_isolates data set to better reflect reality • Added more microorganisms codes from laboratory systems (esp. species of Pseudescherichia and Rodentibacter) • Added Gram-stain to mo_info() #### Other • Rewrote the complete documentation to markdown format, to be able to use the very latest version of the great Roxygen2, released in November 2019. This tremously improved the documentation quality, since the rewrite forced us to go over all texts again and make changes where needed. • Change dependency on clean to cleaner, as this package was renamed accordingly upon CRAN request • Added Dr. Sofia Ny as contributor #### Breaking • Determination of first isolates now excludes all ‘unknown’ microorganisms at default, i.e. microbial code "UNKNOWN". They can be included with the new argument include_unknown:  first_isolate(..., include_unknown = TRUE) For WHONET users, this means that all records/isolates with organism code "con" (contamination) will be excluded at default, since as.mo("con") = "UNKNOWN". The function always shows a note with the number of ‘unknown’ microorganisms that were included or excluded. • For code consistency, classes ab and mo will now be preserved in any subsetting or assignment. For the sake of data integrity, this means that invalid assignments will now result in NA:  # how it works in base R: x <- factor("A") x[1] <- "B" #> Warning message: #> invalid factor level, NA generated # how it now works similarly for classes 'mo' and 'ab': x <- as.mo("E. coli") x[1] <- "testvalue" #> Warning message: #> invalid microorganism code, NA generated This is important, because a value like "testvalue" could never be understood by e.g. mo_name(), although the class would suggest a valid microbial code. • Function freq() has moved to a new package, clean (CRAN link), since creating frequency tables actually does not fit the scope of this package. The freq() function still works, since it is re-exported from the clean package (which will be installed automatically upon updating this AMR package). • Renamed data set septic_patients to example_isolates #### New • Function bug_drug_combinations() to quickly get a data.frame with the results of all bug-drug combinations in a data set. The column containing microorganism codes is guessed automatically and its input is transformed with mo_shortname() at default:  x <- bug_drug_combinations(example_isolates) #> NOTE: Using column mo as input for col_mo. x[1:4, ] #> mo ab S I R total #> 1 A. baumannii AMC 0 0 3 3 #> 2 A. baumannii AMK 0 0 0 0 #> 3 A. baumannii AMP 0 0 3 3 #> 4 A. baumannii AMX 0 0 3 3 #> NOTE: Use 'format()' on this result to get a publicable/printable format. # change the transformation with the FUN argument to anything you like: x <- bug_drug_combinations(example_isolates, FUN = mo_gramstain) #> NOTE: Using column mo as input for col_mo. x[1:4, ] #> mo ab S I R total #> 1 Gram-negative AMC 469 89 174 732 #> 2 Gram-negative AMK 251 0 2 253 #> 3 Gram-negative AMP 227 0 405 632 #> 4 Gram-negative AMX 227 0 405 632 #> NOTE: Use 'format()' on this result to get a publicable/printable format. You can format this to a printable format, ready for reporting or exporting to e.g. Excel with the base R format() function:  format(x, combine_IR = FALSE) • Additional way to calculate co-resistance, i.e. when using multiple antimicrobials as input for portion_* functions or count_* functions. This can be used to determine the empiric susceptibility of a combination therapy. A new argument only_all_tested (which defaults to FALSE) replaces the old also_single_tested and can be used to select one of the two methods to count isolates and calculate portions. The difference can be seen in this example table (which is also on the portion and count help pages), where the %SI is being determined:  # -------------------------------------------------------------------- # only_all_tested = FALSE only_all_tested = TRUE # ----------------------- ----------------------- # Drug A Drug B include as include as include as include as # numerator denominator numerator denominator # -------- -------- ---------- ----------- ---------- ----------- # S or I S or I X X X X # R S or I X X X X # <NA> S or I X X - - # S or I R X X X X # R R - X - X # <NA> R - - - - # S or I <NA> X X - - # R <NA> - - - - # <NA> <NA> - - - - # -------------------------------------------------------------------- Since this is a major change, usage of the old also_single_tested will throw an informative error that it has been replaced by only_all_tested. • tibble printing support for classes rsi, mic, disk, ab mo. When using tibbles containing antimicrobial columns, values S will print in green, values I will print in yellow and values R will print in red. Microbial IDs (class mo) will emphasise on the genus and species, not on the kingdom.  # (run this on your own console, as this page does not support colour printing) library(dplyr) example_isolates %>% select(mo:AMC) %>% as_tibble() #### Changed • Many algorithm improvements for as.mo() (of which some led to additions to the microorganisms data set). Many thanks to all contributors that helped improving the algorithms. • Self-learning algorithm - the function now gains experience from previously determined microorganism IDs and learns from it (yielding 80-95% speed improvement for any guess after the first try) • Big improvement for misspelled input • These new trivial names known to the field are now understood: meningococcus, gonococcus, pneumococcus • Updated to the latest taxonomic data (updated to August 2019, from the International Journal of Systematic and Evolutionary Microbiology • Added support for Viridans Group Streptococci (VGS) and Milleri Group Streptococci (MGS) • Added support for Blastocystis • Added support for 5,000 new fungi • Added support for unknown yeasts and fungi • Changed most microorganism IDs to improve readability. For example, the old code B_ENTRC_FAE could have been both E. faecalis and E. faecium. Its new code is B_ENTRC_FCLS and E. faecium has become B_ENTRC_FACM. Also, the Latin character ae is now preserved at the start of each genus and species abbreviation. For example, the old code for Aerococcus urinae was B_ARCCC_NAE. This is now B_AERCC_URIN. IMPORTANT: Old microorganism IDs are still supported, but support will be dropped in a future version. Use as.mo() on your old codes to transform them to the new format. Using functions from the mo_* family (like mo_name() and mo_gramstain()) on old codes, will throw a warning. • More intelligent guessing for as.ab(), including bidirectional language support • Added support for the German national guideline (3MRGN/4MRGN) in the mdro() function, to determine multi-drug resistant organisms • Function eucast_rules(): • Fixed a bug for Yersinia pseudotuberculosis • Added more informative errors and warnings • Printed info now distinguishes between added and changes values • Using Verbose mode (i.e. eucast_rules(..., verbose = TRUE)) returns more informative and readable output • Using factors as input now adds missing factors levels when the function changes antibiotic results • Improved the internal auto-guessing function for determining antimicrobials in your data set (AMR:::get_column_abx()) • Removed class atc - using as.atc() is now deprecated in favour of ab_atc() and this will return a character, not the atc class anymore • Removed deprecated functions abname(), ab_official(), atc_name(), atc_official(), atc_property(), atc_tradenames(), atc_trivial_nl() • Fix and speed improvement for mo_shortname() • Fix for using mo_* functions where the coercion uncertainties and failures would not be available through mo_uncertainties() and mo_failures() anymore • Deprecated the country argument of mdro() in favour of the already existing guideline argument to support multiple guidelines within one country • The name of RIF is now Rifampicin instead of Rifampin • The antibiotics data set is now sorted by name and all cephalosporins now have their generation between brackets • Speed improvement for guess_ab_col() which is now 30 times faster for antibiotic abbreviations • Improved filter_ab_class() to be more reliable and to support 5th generation cephalosporins • Function availability() now uses portion_R() instead of portion_IR(), to comply with EUCAST insights • Functions age() and age_groups() now have a na.rm argument to remove empty values • Renamed function p.symbol() to p_symbol() (the former is now deprecated and will be removed in a future version) • Using negative values for x in age_groups() will now introduce NAs and not return an error anymore • Fix for determining the system’s language • Fix for key_antibiotics() on foreign systems • Added 80 new LIS codes for microorganisms • Relabeled the factor levels of mdr_tb() • Added more MIC factor levels (as.mic()) ##### Other • Added Prof. Dr. Casper Albers as doctoral advisor and added Dr. Judith Fonville, Eric Hazenberg, Dr. Bart Meijer, Dr. Dennis Souverein and Annick Lenglet as contributors • Cleaned the coding style of every single syntax line in this package with the help of the lintr package ##### New • Function rsi_df() to transform a data.frame to a data set containing only the microbial interpretation (S, I, R), the antibiotic, the percentage of S/I/R and the number of available isolates. This is a convenient combination of the existing functions count_df() and portion_df() to immediately show resistance percentages and number of available isolates:  septic_patients %>% select(AMX, CIP) %>% rsi_df() # antibiotic interpretation value isolates # 1 Amoxicillin SI 0.4442636 546 # 2 Amoxicillin R 0.5557364 683 # 3 Ciprofloxacin SI 0.8381831 1181 # 4 Ciprofloxacin R 0.1618169 228 • Support for all scientifically published pathotypes of E. coli to date (that we could find). Supported are: • AIEC (Adherent-Invasive E. coli) • ATEC (Atypical Entero-pathogenic E. coli) • DAEC (Diffusely Adhering E. coli) • EAEC (Entero-Aggresive E. coli) • EHEC (Entero-Haemorrhagic E. coli) • EIEC (Entero-Invasive E. coli) • EPEC (Entero-Pathogenic E. coli) • ETEC (Entero-Toxigenic E. coli) • NMEC (Neonatal Meningitis-causing E. coli) • STEC (Shiga-toxin producing E. coli) • UPEC (Uropathogenic E. coli) All these lead to the microbial ID of E. coli:  as.mo("UPEC") # B_ESCHR_COL mo_name("UPEC") # "Escherichia coli" mo_gramstain("EHEC") # "Gram-negative" • Function mo_info() as an analogy to ab_info(). The mo_info() prints a list with the full taxonomy, authors, and the URL to the online database of a microorganism • Function mo_synonyms() to get all previously accepted taxonomic names of a microorganism ##### Changed • Column names of output count_df() and portion_df() are now lowercase • Fixed bug in translation of microorganism names • Fixed bug in determining taxonomic kingdoms • Algorithm improvements for as.ab() and as.mo() to understand even more severely misspelled input • Function as.ab() now allows spaces for coercing antibiotics names • Added ggplot2 methods for automatically determining the scale type of classes mo and ab • Added names of object in the header in frequency tables, even when using pipes • Prevented "bacteria" from getting coerced by as.ab() because Bacterial is a brand name of trimethoprim (TMP) • Fixed a bug where setting an antibiotic would not work for eucast_rules() and mdro() • Fixed a EUCAST rule for Staphylococci, where amikacin resistance would not be inferred from tobramycin • Removed latest_annual_release from the catalogue_of_life_version() function • Removed antibiotic code PVM1 from the antibiotics data set as this was a duplicate of PME • Fixed bug where not all old taxonomic names would be printed, when using a vector as input for as.mo() • Manually added Trichomonas vaginalis from the kingdom of Protozoa, which is missing from the Catalogue of Life • Small improvements to plot() and barplot() for MIC and RSI classes • Allow Catalogue of Life IDs to be coerced by as.mo() ##### Other • Fixed a note thrown by CRAN tests ##### New • Support for translation of disk diffusion and MIC values to RSI values (i.e. antimicrobial interpretations). Supported guidelines are EUCAST (2011 to 2019) and CLSI (2011 to 2019). Use as.rsi() on an MIC value (created with as.mic()), a disk diffusion value (created with the new as.disk()) or on a complete date set containing columns with MIC or disk diffusion values. • Function mo_name() as alias of mo_fullname() • Added guidelines of the WHO to determine multi-drug resistance (MDR) for TB (mdr_tb()) and added a new vignette about MDR. Read this tutorial here on our website. ##### Changed • Fixed a critical bug in first_isolate() where missing species would lead to incorrect FALSEs. This bug was not present in AMR v0.5.0, but was in v0.6.0 and v0.6.1. • Fixed a bug in eucast_rules() where antibiotics from WHONET software would not be recognised • Completely reworked the antibiotics data set: • All entries now have 3 different identifiers: • Column ab contains a human readable EARS-Net code, used by ECDC and WHO/WHONET - this is the primary identifier used in this package • Column atc contains the ATC code, used by WHO/WHOCC • Column cid contains the CID code (Compound ID), used by PubChem • Based on the Compound ID, almost 5,000 official brand names have been added from many different countries • All references to antibiotics in our package now use EARS-Net codes, like AMX for amoxicillin • Functions atc_certe, ab_umcg and atc_trivial_nl have been removed • All atc_* functions are superseded by ab_* functions • All output will be translated by using an included translation file which can be viewed here • Improvements to plotting AMR results with ggplot_rsi(): • New argument colours to set the bar colours • New arguments title, subtitle, caption, x.title and y.title to set titles and axis descriptions • Improved intelligence of looking up antibiotic columns in a data set using guess_ab_col() • Added ~5,000 more old taxonomic names to the microorganisms.old data set, which leads to better results finding when using the as.mo() function • This package now honours the new EUCAST insight (2019) that S and I are but classified as susceptible, where I is defined as ‘increased exposure’ and not ‘intermediate’ anymore. For functions like portion_df() and count_df() this means that their new argument combine_SI is TRUE at default. Our plotting function ggplot_rsi() also reflects this change since it uses count_df() internally. • The age() function gained a new argument exact to determine ages with decimals • Removed deprecated functions guess_mo(), guess_atc(), EUCAST_rules(), interpretive_reading(), rsi() • Frequency tables (freq()): • speed improvement for microbial IDs • fixed factor level names for R Markdown • when all values are unique it now shows a message instead of a warning • support for boxplots:  septic_patients %>% freq(age) %>% boxplot() # grouped boxplots: septic_patients %>% group_by(hospital_id) %>% freq(age) %>% boxplot() • Removed all hardcoded EUCAST rules and replaced them with a new reference file which can be viewed here • Added ceftazidim intrinsic resistance to Streptococci • Changed default settings for age_groups(), to let groups of fives and tens end with 100+ instead of 120+ • Fix for freq() for when all values are NA • Fix for first_isolate() for when dates are missing • Improved speed of guess_ab_col() • Function as.mo() now gently interprets any number of whitespace characters (like tabs) as one space • Function as.mo() now returns UNKNOWN for "con" (WHONET ID of ‘contamination’) and returns NA for "xxx"(WHONET ID of ‘no growth’) • Small algorithm fix for as.mo() • Removed viruses from data set microorganisms.codes and cleaned it up • Fix for mo_shortname() where species would not be determined correctly ##### Other • Support for R 3.6.0 and later by providing support for staged install ##### Changed • Fixed a critical bug when using eucast_rules() with verbose = TRUE • Coercion of microbial IDs are now written to the package namespace instead of the user’s home folder, to comply with the CRAN policy New website! We’ve got a new website: https://msberends.gitlab.io/AMR (built with the great pkgdown) • Contains the complete manual of this package and all of its functions with an explanation of their arguments • Contains a comprehensive tutorial about how to conduct AMR data analysis, import data from WHONET or SPSS and many more. ##### New • BREAKING: removed deprecated functions, arguments and references to ‘bactid’. Use as.mo() to identify an MO code. • Catalogue of Life as a new taxonomic source for data about microorganisms, which also contains all ITIS data we used previously. The microorganisms data set now contains: • All ~55,000 (sub)species from the kingdoms of Archaea, Bacteria and Protozoa • All ~3,000 (sub)species from these orders of the kingdom of Fungi: Eurotiales, Onygenales, Pneumocystales, Saccharomycetales and Schizosaccharomycetales (covering at least like all species of Aspergillus, Candida, Pneumocystis, Saccharomyces and Trichophyton) • All ~2,000 (sub)species from ~100 other relevant genera, from the kingdoms of Animalia and Plantae (like Strongyloides and Taenia) • All ~15,000 previously accepted names of included (sub)species that have been taxonomically renamed • The responsible author(s) and year of scientific publication This data is updated annually - check the included version with the new function catalogue_of_life_version(). • Due to this change, some mo codes changed (e.g. Streptococcus changed from B_STRPTC to B_STRPT). A translation table is used internally to support older microorganism IDs, so users will not notice this difference. • New function mo_rank() for the taxonomic rank (genus, species, infraspecies, etc.) • New function mo_url() to get the direct URL of a species from the Catalogue of Life • Support for data from WHONET and EARS-Net (European Antimicrobial Resistance Surveillance Network): • Exported files from WHONET can be read and used in this package. For functions like first_isolate() and eucast_rules(), all arguments will be filled in automatically. • This package now knows all antibiotic abbrevations by EARS-Net (which are also being used by WHONET) - the antibiotics data set now contains a column ears_net. • The function as.mo() now knows all WHONET species abbreviations too, because almost 2,000 microbial abbreviations were added to the microorganisms.codes data set. • New filters for antimicrobial classes. Use these functions to filter isolates on results in one of more antibiotics from a specific class:  filter_aminoglycosides() filter_carbapenems() filter_cephalosporins() filter_1st_cephalosporins() filter_2nd_cephalosporins() filter_3rd_cephalosporins() filter_4th_cephalosporins() filter_fluoroquinolones() filter_glycopeptides() filter_macrolides() filter_tetracyclines() The antibiotics data set will be searched, after which the input data will be checked for column names with a value in any abbreviations, codes or official names found in the antibiotics data set. For example:  septic_patients %>% filter_glycopeptides(result = "R") # Filtering on glycopeptide antibacterials: any of vanc or teic is R septic_patients %>% filter_glycopeptides(result = "R", scope = "all") # Filtering on glycopeptide antibacterials: all of vanc and teic is R • All ab_* functions are deprecated and replaced by atc_* functions:  ab_property -> atc_property() ab_name -> atc_name() ab_official -> atc_official() ab_trivial_nl -> atc_trivial_nl() ab_certe -> atc_certe() ab_umcg -> atc_umcg() ab_tradenames -> atc_tradenames() These functions use as.atc() internally. The old atc_property has been renamed atc_online_property(). This is done for two reasons: firstly, not all ATC codes are of antibiotics (ab) but can also be of antivirals or antifungals. Secondly, the input must have class atc or must be coerable to this class. Properties of these classes should start with the same class name, analogous to as.mo() and e.g. mo_genus. • New functions set_mo_source() and get_mo_source() to use your own predefined MO codes as input for as.mo() and consequently all mo_* functions • Support for the upcoming dplyr version 0.8.0 • New function guess_ab_col() to find an antibiotic column in a table • New function mo_failures() to review values that could not be coerced to a valid MO code, using as.mo(). This latter function will now only show a maximum of 10 uncoerced values and will refer to mo_failures(). • New function mo_uncertainties() to review values that could be coerced to a valid MO code using as.mo(), but with uncertainty. • New function mo_renamed() to get a list of all returned values from as.mo() that have had taxonomic renaming • New function age() to calculate the (patients) age in years • New function age_groups() to split ages into custom or predefined groups (like children or elderly). This allows for easier demographic AMR data analysis per age group. • New function ggplot_rsi_predict() as well as the base R plot() function can now be used for resistance prediction calculated with resistance_predict():  x <- resistance_predict(septic_patients, col_ab = "amox") plot(x) ggplot_rsi_predict(x) • Functions filter_first_isolate() and filter_first_weighted_isolate() to shorten and fasten filtering on data sets with antimicrobial results, e.g.:  septic_patients %>% filter_first_isolate(...) # or filter_first_isolate(septic_patients, ...) is equal to:  septic_patients %>% mutate(only_firsts = first_isolate(septic_patients, ...)) %>% filter(only_firsts == TRUE) %>% select(-only_firsts) • New function availability() to check the number of available (non-empty) results in a data.frame • New vignettes about how to conduct AMR analysis, predict antimicrobial resistance, use the G-test and more. These are also available (and even easier readable) on our website: https://msberends.gitlab.io/AMR. ##### Changed • Function eucast_rules(): • Updated EUCAST Clinical breakpoints to version 9.0 of 1 January 2019, the data set septic_patients now reflects these changes • Fixed a critical bug where some rules that depend on previous applied rules would not be applied adequately • Emphasised in manual that penicillin is meant as benzylpenicillin (ATC J01CE01) • New info is returned when running this function, stating exactly what has been changed or added. Use eucast_rules(..., verbose = TRUE) to get a data set with all changed per bug and drug combination. • Removed data sets microorganisms.oldDT, microorganisms.prevDT, microorganisms.unprevDT and microorganismsDT since they were no longer needed and only contained info already available in the microorganisms data set • Added 65 antibiotics to the antibiotics data set, from the Pharmaceuticals Community Register of the European Commission • Removed columns atc_group1_nl and atc_group2_nl from the antibiotics data set • Functions atc_ddd() and atc_groups() have been renamed atc_online_ddd() and atc_online_groups(). The old functions are deprecated and will be removed in a future version. • Function guess_mo() is now deprecated in favour of as.mo() and will be removed in future versions • Function guess_atc() is now deprecated in favour of as.atc() and will be removed in future versions • Improvements for as.mo(): • Now handles incorrect spelling, like i instead of y and f instead of ph:  # mo_fullname() uses as.mo() internally mo_fullname("Sthafilokockus aaureuz") #> [1] "Staphylococcus aureus" mo_fullname("S. klossi") #> [1] "Staphylococcus kloosii" • Uncertainty of the algorithm is now divided into four levels, 0 to 3, where the default allow_uncertain = TRUE is equal to uncertainty level 2. Run ?as.mo for more info about these levels.  # equal: as.mo(..., allow_uncertain = TRUE) as.mo(..., allow_uncertain = 2) # also equal: as.mo(..., allow_uncertain = FALSE) as.mo(..., allow_uncertain = 0) Using as.mo(..., allow_uncertain = 3) could lead to very unreliable results. • Implemented the latest publication of Becker et al. (2019), for categorising coagulase-negative Staphylococci • All microbial IDs that found are now saved to a local file ~/.Rhistory_mo. Use the new function clean_mo_history() to delete this file, which resets the algorithms. • Incoercible results will now be considered ‘unknown’, MO code UNKNOWN. On foreign systems, properties of these will be translated to all languages already previously supported: German, Dutch, French, Italian, Spanish and Portuguese. • Fix for vector containing only empty values • Finds better results when input is in other languages • Better handling for subspecies • Better handling for Salmonellae, especially the ‘city like’ serovars like Salmonella London • Understanding of highly virulent E. coli strains like EIEC, EPEC and STEC • There will be looked for uncertain results at default - these results will be returned with an informative warning • Manual (help page) now contains more info about the algorithms • Progress bar will be shown when it takes more than 3 seconds to get results • Support for formatted console text • Console will return the percentage of uncoercable input • Function first_isolate(): • Fixed a bug where distances between dates would not be calculated right - in the septic_patients data set this yielded a difference of 0.15% more isolates • Will now use a column named like “patid” for the patient ID (argument col_patientid), when this argument was left blank • Will now use a column named like “key(…)ab” or “key(…)antibiotics” for the key antibiotics (argument col_keyantibiotics()), when this argument was left blank • Removed argument output_logical, the function will now always return a logical value • Renamed argument filter_specimen to specimen_group, although using filter_specimen will still work • A note to the manual pages of the portion functions, that low counts can influence the outcome and that the portion functions may camouflage this, since they only return the portion (albeit being dependent on the minimum argument) • Merged data sets microorganisms.certe and microorganisms.umcg into microorganisms.codes • Function mo_taxonomy() now contains the kingdom too • Reduce false positives for is.rsi.eligible() using the new threshold argument • New colours for scale_rsi_colours() • Summaries of class mo will now return the top 3 and the unique count, e.g. using summary(mo) • Small text updates to summaries of class rsi and mic • Function as.rsi(): • Now gives a warning when inputting MIC values • Now accepts high and low resistance: "HIGH S" will return S • Frequency tables (freq() function): • Support for tidyverse quasiquotation! Now you can create frequency tables of function outcomes:  # Determine genus of microorganisms (mo) in septic_patients data set: # OLD WAY septic_patients %>% mutate(genus = mo_genus(mo)) %>% freq(genus) # NEW WAY septic_patients %>% freq(mo_genus(mo)) # Even supports grouping variables: septic_patients %>% group_by(gender) %>% freq(mo_genus(mo)) • Header info is now available as a list, with the header function • The argument header is now set to TRUE at default, even for markdown • Added header info for class mo to show unique count of families, genera and species • Now honours the decimal.mark setting, which just like format defaults to getOption("OutDec") • The new big.mark argument will at default be "," when decimal.mark = "." and "." otherwise • Fix for header text where all observations are NA • New argument droplevels to exclude empty factor levels when input is a factor • Factor levels will be in header when present in input data (maximum of 5) • Fix for using select() on frequency tables • Function scale_y_percent() now contains the limits argument • Automatic argument filling for mdro(), key_antibiotics() and eucast_rules() • Updated examples for resistance prediction (resistance_predict() function) • Fix for as.mic() to support more values ending in (several) zeroes • if using different lengths of pattern and x in %like%, it will now return the call ##### Other • Updated licence text to emphasise GPL 2.0 and that this is an R package. ##### New • Repository moved to GitLab • Function count_all to get all available isolates (that like all portion_* and count_* functions also supports summarise and group_by), the old n_rsi is now an alias of count_all • Function get_locale to determine language for language-dependent output for some mo_* functions. This is now the default value for their language argument, by which the system language will be used at default. • Data sets microorganismsDT, microorganisms.prevDT, microorganisms.unprevDT and microorganisms.oldDT to improve the speed of as.mo. They are for reference only, since they are primarily for internal use of as.mo. • Function read.4D to read from the 4D database of the MMB department of the UMCG • Functions mo_authors and mo_year to get specific values about the scientific reference of a taxonomic entry ##### Changed • Functions MDRO, BRMO, MRGN and EUCAST_exceptional_phenotypes were renamed to mdro, brmo, mrgn and eucast_exceptional_phenotypes • EUCAST_rules was renamed to eucast_rules, the old function still exists as a deprecated function • Big changes to the eucast_rules function: • Now also applies rules from the EUCAST ‘Breakpoint tables for bacteria’, version 8.1, 2018, https://www.eucast.org/clinical_breakpoints/ (see Source of the function) • New argument rules to specify which rules should be applied (expert rules, breakpoints, others or all) • New argument verbose which can be set to TRUE to get very specific messages about which columns and rows were affected • Better error handling when rules cannot be applied (i.e. new values could not be inserted) • The number of affected values will now only be measured once per row/column combination • Data set septic_patients now reflects these changes • Added argument pipe for piperacillin (J01CA12), also to the mdro function • Small fixes to EUCAST clinical breakpoint rules • Added column kingdom to the microorganisms data set, and function mo_kingdom to look up values • Tremendous speed improvement for as.mo (and subsequently all mo_* functions), as empty values wil be ignored a priori • Fewer than 3 characters as input for as.mo will return NA • Function as.mo (and all mo_* wrappers) now supports genus abbreviations with “species” attached  as.mo("E. species") # B_ESCHR mo_fullname("E. spp.") # "Escherichia species" as.mo("S. spp") # B_STPHY mo_fullname("S. species") # "Staphylococcus species" • Added argument combine_IR (TRUE/FALSE) to functions portion_df and count_df, to indicate that all values of I and R must be merged into one, so the output only consists of S vs. IR (susceptible vs. non-susceptible) • Fix for portion_*(..., as_percent = TRUE) when minimal number of isolates would not be met • Added argument also_single_tested for portion_* and count_* functions to also include cases where not all antibiotics were tested but at least one of the tested antibiotics includes the target antimicribial interpretation, see ?portion • Using portion_* functions now throws a warning when total available isolate is below argument minimum • Functions as.mo, as.rsi, as.mic, as.atc and freq will not set package name as attribute anymore • Frequency tables - freq(): • Support for grouping variables, test with:  septic_patients %>% group_by(hospital_id) %>% freq(gender) • Support for (un)selecting columns:  septic_patients %>% freq(hospital_id) %>% select(-count, -cum_count) # only get item, percent, cum_percent • Check for hms::is.hms • Now prints in markdown at default in non-interactive sessions • No longer adds the factor level column and sorts factors on count again • Support for class difftime • New argument na, to choose which character to print for empty values • New argument header to turn the header info off (default when markdown = TRUE) • New argument title to manually setbthe title of the frequency table • first_isolate now tries to find columns to use as input when arguments are left blank • Improvements for MDRO algorithm (function mdro) • Data set septic_patients is now a data.frame, not a tibble anymore • Removed diacritics from all authors (columns microorganisms$ref and microorganisms.old$ref) to comply with CRAN policy to only allow ASCII characters • Fix for mo_property not working properly • Fix for eucast_rules where some Streptococci would become ceftazidime R in EUCAST rule 4.5 • Support for named vectors of class mo, useful for top_freq() • ggplot_rsi and scale_y_percent have breaks argument • AI improvements for as.mo: • "CRS" -> Stenotrophomonas maltophilia • "CRSM" -> Stenotrophomonas maltophilia • "MSSA" -> Staphylococcus aureus • "MSSE" -> Staphylococcus epidermidis • Fix for join functions • Speed improvement for is.rsi.eligible, now 15-20 times faster • In g.test, when sum(x) is below 1000 or any of the expected values is below 5, Fisher’s Exact Test will be suggested • ab_name will try to fall back on as.atc when no results are found • Removed the addin to view data sets • Percentages will now will rounded more logically (e.g. in freq function) ##### Other • New dependency on package crayon, to support formatted text in the console • Dependency tidyr is now mandatory (went to Import field) since portion_df and count_df rely on it • Updated vignettes to comply with README ##### New • The data set microorganisms now contains all microbial taxonomic data from ITIS (kingdoms Bacteria, Fungi and Protozoa), the Integrated Taxonomy Information System, available via https://itis.gov. The data set now contains more than 18,000 microorganisms with all known bacteria, fungi and protozoa according ITIS with genus, species, subspecies, family, order, class, phylum and subkingdom. The new data set microorganisms.old contains all previously known taxonomic names from those kingdoms. • New functions based on the existing function mo_property: • Taxonomic names: mo_phylum, mo_class, mo_order, mo_family, mo_genus, mo_species, mo_subspecies • Semantic names: mo_fullname, mo_shortname • Microbial properties: mo_type, mo_gramstain • Author and year: mo_ref They also come with support for German, Dutch, French, Italian, Spanish and Portuguese:  mo_gramstain("E. coli") # [1] "Gram negative" mo_gramstain("E. coli", language = "de") # German # [1] "Gramnegativ" mo_gramstain("E. coli", language = "es") # Spanish # [1] "Gram negativo" mo_fullname("S. group A", language = "pt") # Portuguese # [1] "Streptococcus grupo A" Furthermore, former taxonomic names will give a note about the current taxonomic name:  mo_gramstain("Esc blattae") # Note: 'Escherichia blattae' (Burgess et al., 1973) was renamed 'Shimwellia blattae' (Priest and Barker, 2010) # [1] "Gram negative" • Functions count_R, count_IR, count_I, count_SI and count_S to selectively count resistant or susceptible isolates • Extra function count_df (which works like portion_df) to get all counts of S, I and R of a data set with antibiotic columns, with support for grouped variables • Function is.rsi.eligible to check for columns that have valid antimicrobial results, but do not have the rsi class yet. Transform the columns of your raw data with: data %>% mutate_if(is.rsi.eligible, as.rsi) • Functions as.mo and is.mo as replacements for as.bactid and is.bactid (since the microoganisms data set not only contains bacteria). These last two functions are deprecated and will be removed in a future release. The as.mo function determines microbial IDs using intelligent rules:  as.mo("E. coli") # [1] B_ESCHR_COL as.mo("MRSA") # [1] B_STPHY_AUR as.mo("S group A") # [1] B_STRPTC_GRA And with great speed too - on a quite regular Linux server from 2007 it takes us less than 0.02 seconds to transform 25,000 items:  thousands_of_E_colis <- rep("E. coli", 25000) microbenchmark::microbenchmark(as.mo(thousands_of_E_colis), unit = "s") # Unit: seconds # min median max neval # 0.01817717 0.01843957 0.03878077 100 • Added argument reference_df for as.mo, so users can supply their own microbial IDs, name or codes as a reference table • Renamed all previous references to bactid to mo, like: • Column names inputs of EUCAST_rules, first_isolate and key_antibiotics • Column names of datasets microorganisms and septic_patients • All old syntaxes will still work with this version, but will throw warnings • Function labels_rsi_count to print datalabels on a RSI ggplot2 model • Functions as.atc and is.atc to transform/look up antibiotic ATC codes as defined by the WHO. The existing function guess_atc is now an alias of as.atc. • Function ab_property and its aliases: ab_name, ab_tradenames, ab_certe, ab_umcg and ab_trivial_nl • Introduction to AMR as a vignette • Removed clipboard functions as it violated the CRAN policy • Renamed septic_patients$sex to septic_patients$gender ##### Changed • Added three antimicrobial agents to the antibiotics data set: Terbinafine (D01BA02), Rifaximin (A07AA11) and Isoconazole (D01AC05) • Added 163 trade names to the antibiotics data set, it now contains 298 different trade names in total, e.g.:  ab_official("Bactroban") # [1] "Mupirocin" ab_name(c("Bactroban", "Amoxil", "Zithromax", "Floxapen")) # [1] "Mupirocin" "Amoxicillin" "Azithromycin" "Flucloxacillin" ab_atc(c("Bactroban", "Amoxil", "Zithromax", "Floxapen")) # [1] "R01AX06" "J01CA04" "J01FA10" "J01CF05" • For first_isolate, rows will be ignored when there’s no species available • Function ratio is now deprecated and will be removed in a future release, as it is not really the scope of this package • Fix for as.mic for values ending in zeroes after a real number • Small fix where B. fragilis would not be found in the microorganisms.umcg data set • Added prevalence column to the microorganisms data set • Added arguments minimum and as_percent to portion_df • Support for quasiquotation in the functions series count_* and portions_*, and n_rsi. This allows to check for more than 2 vectors or columns.  septic_patients %>% select(amox, cipr) %>% count_IR() # which is the same as: septic_patients %>% count_IR(amox, cipr) septic_patients %>% portion_S(amcl) septic_patients %>% portion_S(amcl, gent) septic_patients %>% portion_S(amcl, gent, pita) • Edited ggplot_rsi and geom_rsi so they can cope with count_df. The new fun argument has value portion_df at default, but can be set to count_df. • Fix for ggplot_rsi when the ggplot2 package was not loaded • Added datalabels function labels_rsi_count to ggplot_rsi • Added possibility to set any argument to geom_rsi (and ggplot_rsi) so you can set your own preferences • Fix for joins, where predefined suffices would not be honoured • Added argument quote to the freq function • Added generic function diff for frequency tables • Added longest en shortest character length in the frequency table (freq) header of class character • Support for types (classes) list and matrix for freq  my_matrix = with(septic_patients, matrix(c(age, gender), ncol = 2)) freq(my_matrix) For lists, subsetting is possible:  my_list = list(age = septic_patients$age, gender = septic_patients$gender) my_list %>% freq(age) my_list %>% freq(gender) ##### Other • More unit tests to ensure better integrity of functions ##### New • BREAKING: rsi_df was removed in favour of new functions portion_R, portion_IR, portion_I, portion_SI and portion_S to selectively calculate resistance or susceptibility. These functions are 20 to 30 times faster than the old rsi function. The old function still works, but is deprecated. • New function portion_df to get all portions of S, I and R of a data set with antibiotic columns, with support for grouped variables • BREAKING: the methodology for determining first weighted isolates was changed. The antibiotics that are compared between isolates (call key antibiotics) to include more first isolates (afterwards called first weighted isolates) are now as follows: • Universal: amoxicillin, amoxicillin/clavlanic acid, cefuroxime, piperacillin/tazobactam, ciprofloxacin, trimethoprim/sulfamethoxazole • Gram-positive: vancomycin, teicoplanin, tetracycline, erythromycin, oxacillin, rifampicin • Gram-negative: gentamicin, tobramycin, colistin, cefotaxime, ceftazidime, meropenem • Support for ggplot2 • New functions geom_rsi, facet_rsi, scale_y_percent, scale_rsi_colours and theme_rsi • New wrapper function ggplot_rsi to apply all above functions on a data set: • septic_patients %>% select(tobr, gent) %>% ggplot_rsi will show portions of S, I and R immediately in a pretty plot • Support for grouped variables, see ?ggplot_rsi • Determining bacterial ID: • New functions as.bactid and is.bactid to transform/ look up microbial ID’s. • The existing function guess_bactid is now an alias of as.bactid • New Becker classification for Staphylococcus to categorise them into Coagulase Negative Staphylococci (CoNS) and Coagulase Positve Staphylococci (CoPS) • New Lancefield classification for Streptococcus to categorise them into Lancefield groups • For convience, new descriptive statistical functions kurtosis and skewness that are lacking in base R - they are generic functions and have support for vectors, data.frames and matrices • Function g.test to perform the X2 distributed G-test, which use is the same as chisq.test • Function ratio to transform a vector of values to a preset ratio • For example: ratio(c(10, 500, 10), ratio = "1:2:1") would return 130, 260, 130 • Support for Addins menu in RStudio to quickly insert %in% or %like% (and give them keyboard shortcuts), or to view the datasets that come with this package • Function p.symbol to transform p values to their related symbols: 0 '***' 0.001 '**' 0.01 '*' 0.05 '.' 0.1 ' ' 1 • Functions clipboard_import and clipboard_export as helper functions to quickly copy and paste from/to software like Excel and SPSS. These functions use the clipr package, but are a little altered to also support headless Linux servers (so you can use it in RStudio Server) • New for frequency tables (function freq): • A vignette to explain its usage • Support for rsi (antimicrobial resistance) to use as input • Support for table to use as input: freq(table(x, y)) • Support for existing functions hist and plot to use a frequency table as input: hist(freq(df$age))
• Support for as.vector, as.data.frame, as_tibble and format
• Support for quasiquotation: freq(mydata, mycolumn) is the same as mydata %>% freq(mycolumn)
• Function top_freq function to return the top/below n items as vector
• Header of frequency tables now also show Mean Absolute Deviaton (MAD) and Interquartile Range (IQR)
• Possibility to globally set the default for the amount of items to print, with options(max.print.freq = n) where n is your preset value
##### Changed
• Improvements for forecasting with resistance_predict and added more examples
• More antibiotics added as arguments for EUCAST rules
• Updated version of the septic_patients data set to better reflect the reality
• Pretty printing for tibbles removed as it is not really the scope of this package
• Printing of mic and rsi classes now returns all values - use freq to check distributions
• Improved speed of key antibiotics comparison for determining first isolates
• Column names for the key_antibiotics function are now generic: 6 for broadspectrum ABs, 6 for Gram-positive specific and 6 for Gram-negative specific ABs
• Speed improvement for the abname function
• %like% now supports multiple patterns
• Frequency tables are now actual data.frames with altered console printing to make it look like a frequency table. Because of this, the argument toConsole is not longer needed.
• Fix for freq where the class of an item would be lost
• Small translational improvements to the septic_patients dataset and the column bactid now has the new class "bactid"
• Small improvements to the microorganisms dataset (especially for Salmonella) and the column bactid now has the new class "bactid"
• Combined MIC/RSI values will now be coerced by the rsi and mic functions:
• as.rsi("<=0.002; S") will return S
• as.mic("<=0.002; S") will return <=0.002
• Now possible to coerce MIC values with a space between operator and value, i.e. as.mic("<= 0.002") now works
• Classes rsi and mic do not add the attribute package.version anymore
• Added "groups" option for atc_property(..., property). It will return a vector of the ATC hierarchy as defined by the WHO. The new function atc_groups is a convenient wrapper around this.
• Build-in host check for atc_property as it requires the host set by url to be responsive
• Improved first_isolate algorithm to exclude isolates where bacteria ID or genus is unavailable
• Fix for warning hybrid evaluation forced for row_number (924b62) from the dplyr package v0.7.5 and above
• Support for empty values and for 1 or 2 columns as input for guess_bactid (now called as.bactid)
• So yourdata %>% select(genus, species) %>% as.bactid() now also works
• Other small fixes
##### New
• Full support for Windows, Linux and macOS
• Full support for old R versions, only R-3.0.0 (April 2013) or later is needed (needed packages may have other dependencies)
• Function n_rsi to count cases where antibiotic test results were available, to be used in conjunction with dplyr::summarise, see ?rsi
• Function guess_bactid to determine the ID of a microorganism based on genus/species or known abbreviations like MRSA
• Function guess_atc to determine the ATC of an antibiotic based on name, trade name, or known abbreviations
• Function freq to create frequency tables, with additional info in a header
• Function MDRO to determine Multi Drug Resistant Organisms (MDRO) with support for country-specific guidelines.
• Exceptional resistances defined by EUCAST are also supported instead of countries alone
• Functions BRMO and MRGN are wrappers for Dutch and German guidelines, respectively
• New algorithm to determine weighted isolates, can now be "points" or "keyantibiotics", see ?first_isolate
• New print format for tibbles and data.tables
##### Changed
• Fixed rsi class for vectors that contain only invalid antimicrobial interpretations
• Renamed dataset ablist to antibiotics
• Renamed dataset bactlist to microorganisms
• Added common abbreviations and trade names to the antibiotics dataset
• Added more microorganisms to the microorganisms dataset
• Added analysis examples on help page of dataset septic_patients
• Added support for character vector in join functions
• Added warnings when a join results in more rows after than before the join
• Altered %like% to make it case insensitive
• For arguments of functions first_isolate and EUCAST_rules column names are now case-insensitive
• Functions as.rsi and as.mic now add the package name and version as attributes
##### Other
• EUCAST_rules applies for amoxicillin even if ampicillin is missing
• Edited column names to comply with GLIMS, the laboratory information system
• Added more valid MIC values
• Renamed ‘Daily Defined Dose’ to ‘Defined Daily Dose’
• Added barplots for rsi and mic classes
• First submission to CRAN.