In:
PLOS Computational Biology, Public Library of Science (PLoS), Vol. 18, No. 3 ( 2022-3-14), p. e1009875-
Abstract:
Infections caused by antibiotic-resistant bacteria have become more prevalent during past decades. Yet, it is unknown whether such infections occur in addition to infections with antibiotic-susceptible bacteria, thereby increasing the incidence of infections, or whether they replace such infections, leaving the total incidence unaffected. Observational longitudinal studies cannot separate both mechanisms. Using plasmid-based beta-lactam resistant E . coli as example we applied mathematical modelling to investigate whether seven biological mechanisms would lead to replacement or addition of infections. We use a mathematical neutral null model of individuals colonized with susceptible and/or resistant E . coli , with two mechanisms implying a fitness cost, i.e., increased clearance and decreased growth of resistant strains, and five mechanisms benefitting resistance, i.e., 1) increased virulence, 2) increased transmission, 3) decreased clearance of resistant strains, 4) increased rate of horizontal plasmid transfer, and 5) increased clearance of susceptible E . coli due to antibiotics. Each mechanism is modelled separately to estimate addition to or replacement of antibiotic-susceptible infections. Fitness costs cause resistant strains to die out if other strain characteristics are maintained equal. Under the assumptions tested, increased virulence is the only mechanism that increases the total number of infections. Other benefits of resistance lead to replacement of susceptible infections without changing the total number of infections. As there is no biological evidence that plasmid-based beta-lactam resistance increases virulence, these findings suggest that the burden of disease is determined by attributable effects of resistance rather than by an increase in the number of infections.
Type of Medium:
Online Resource
ISSN:
1553-7358
DOI:
10.1371/journal.pcbi.1009875
DOI:
10.1371/journal.pcbi.1009875.g001
DOI:
10.1371/journal.pcbi.1009875.g002
DOI:
10.1371/journal.pcbi.1009875.g003
DOI:
10.1371/journal.pcbi.1009875.g004
DOI:
10.1371/journal.pcbi.1009875.g005
DOI:
10.1371/journal.pcbi.1009875.s001
DOI:
10.1371/journal.pcbi.1009875.s002
DOI:
10.1371/journal.pcbi.1009875.s003
DOI:
10.1371/journal.pcbi.1009875.s004
DOI:
10.1371/journal.pcbi.1009875.s005
DOI:
10.1371/journal.pcbi.1009875.s006
DOI:
10.1371/journal.pcbi.1009875.s007
DOI:
10.1371/journal.pcbi.1009875.s008
DOI:
10.1371/journal.pcbi.1009875.s009
DOI:
10.1371/journal.pcbi.1009875.s010
DOI:
10.1371/journal.pcbi.1009875.s011
DOI:
10.1371/journal.pcbi.1009875.s012
DOI:
10.1371/journal.pcbi.1009875.s013
DOI:
10.1371/journal.pcbi.1009875.s014
DOI:
10.1371/journal.pcbi.1009875.s015
DOI:
10.1371/journal.pcbi.1009875.s016
DOI:
10.1371/journal.pcbi.1009875.s017
DOI:
10.1371/journal.pcbi.1009875.s018
DOI:
10.1371/journal.pcbi.1009875.s019
DOI:
10.1371/journal.pcbi.1009875.s020
DOI:
10.1371/journal.pcbi.1009875.s021
DOI:
10.1371/journal.pcbi.1009875.s022
DOI:
10.1371/journal.pcbi.1009875.s023
DOI:
10.1371/journal.pcbi.1009875.r001
DOI:
10.1371/journal.pcbi.1009875.r002
DOI:
10.1371/journal.pcbi.1009875.r003
DOI:
10.1371/journal.pcbi.1009875.r004
DOI:
10.1371/journal.pcbi.1009875.r005
DOI:
10.1371/journal.pcbi.1009875.r006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2193340-6
Permalink