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建立模型以研究登革热疫苗对减少因登革热病例滥用而导致抗生素耐药性演变的影响。

Modelling the effect of a dengue vaccine on reducing the evolution of resistance against antibiotic due to misuse in dengue cases.

机构信息

School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.

School of Applied Mathematics, Fundacao Getulio Vargas, Rua Praia de Botafogo 190, Rio de Janeiro, CEP - 22250-900, Brazil.

出版信息

Theor Biol Med Model. 2020 May 13;17(1):7. doi: 10.1186/s12976-020-00125-8.

Abstract

BACKGROUND

This paper intends to check whether and how a hypothetical dengue vaccine could contribute to issue of evolution of bacteria resistance against antibiotics by reducing the number of patients that would inappropriately being treated with antibiotics.

METHODS

We use a new mathematical model that combines, in a novel way, two previously published papers, one on the evolution of resistance against antibiotics and one classical Ross-Macdonald model for dengue transmission.

RESULTS

The model is simulated numerically and reproduces a real case of evolution of resistance against antibiotics. In addition the model shows that the use of a hypothetical dengue vaccine could help to curb the evolution of resistance against an antibiotic inappropriately used in dengue patients. Both the increase in the proportion of resistant bacteria due to the misuse of antibiotics in dengue cases as a function of the fraction of treated patients and the reduction of that proportion as a function of vaccination coverage occur in a highly non-linear fashion.

CONCLUSION

The use of a dengue vaccine is helpful in reducing the rate of evolution of antibiotic resistance in a scenario of misuse of the antibiotics in dengue patients.

摘要

背景

本文旨在探讨假设的登革热疫苗是否以及如何通过减少因不当使用抗生素而接受治疗的患者数量,从而对抗生素耐药性的演变产生影响。

方法

我们使用一种新的数学模型,以新颖的方式结合了两篇已发表的论文,一篇是关于抗生素耐药性演变的,另一篇是关于登革热传播的经典罗斯-麦克唐纳模型。

结果

模型进行了数值模拟,并再现了抗生素耐药性演变的实际案例。此外,该模型表明,使用假设的登革热疫苗可能有助于遏制因在登革热患者中不当使用抗生素而产生的耐药性演变。由于在登革热病例中滥用抗生素导致的耐药菌比例的增加以及由于疫苗接种覆盖率的增加而导致的该比例的降低,均以高度非线性的方式发生。

结论

在登革热患者中滥用抗生素的情况下,使用登革热疫苗有助于降低抗生素耐药性的进化速度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd4f/7218541/7e94ae659e35/12976_2020_125_Fig1_HTML.jpg

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