Assessing the Impact of Mutations and Horizontal Gene Transfer on the AMR Control: A Mathematical Model

TL;DR

This paper introduces a mathematical model to analyze how mutations and horizontal gene transfer influence antimicrobial resistance spread, emphasizing control strategies and applying it to European E. coli resistance data.

Contribution

It develops a deterministic model incorporating bacteria interactions and genetic elements, and explores optimal control strategies for AMR reduction.

Findings

Controlling resistance spread in southern Europe is challenging.

Host immune response plays a critical role in AMR control.

Mathematical analysis provides insights into mutation and HGT impacts.

Abstract

Antimicrobial resistance (AMR) poses a significant threat to public health by increasing mortality, extending hospital stays, and increasing healthcare costs. It affects people of all ages and affects health services, veterinary medicine, and agriculture, making it a pressing global issue. Mathematical models are required to predict the behaviour of AMR and to develop control measures to eliminate resistant bacteria or reduce their prevalence. This study presents a simple deterministic mathematical model in which sensitive and resistant bacteria interact in the environment, and mobile genetic elements (MGEs) are functions that depend on resistant bacteria. We analyze the qualitative properties of the model and propose an optimal control problem in which avoiding mutations and horizontal gene transfer (HGT) are the primary control strategies. We also provide a case study of the resistance and multidrug resistance (MDR) percentages of Escherichia coli to gentamicin and amoxicillin in some European countries using data from the European Antimicrobial Resistance Surveillance Network (EARS-Net). Our theoretical results and numerical experiments indicate that controlling the spread of resistance in southern European regions through the supply of amoxicillin is challenging. However, the host immune system is also critical for controlling AMR.