MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France.
Département Tronc Commun, École Polytechnique de Thiès, Thies, Senegal.
J Math Biol. 2023 Oct 27;87(6):78. doi: 10.1007/s00285-023-02008-1.
Understanding both the epidemiological and evolutionary dynamics of antimicrobial resistance is a major public health concern. In this paper, we propose a nested model, explicitly linking the within- and between-host scales, in which the level of resistance of the bacterial population is viewed as a continuous quantitative trait. The within-host dynamics is based on integro-differential equations structured by the resistance level, while the between-host scale is additionally structured by the time since infection. This model simultaneously captures the dynamics of the bacteria population, the evolutionary transient dynamics which lead to the emergence of resistance, and the epidemic dynamics of the host population. Moreover, we precisely analyze the model proposed by particularly performing the uniform persistence and global asymptotic results. Finally, we discuss the impact of the treatment rate of the host population in controlling both the epidemic outbreak and the average level of resistance, either if the within-host scale therapy is a success or failure. We also explore how transitions between infected populations (treated and untreated) can impact the average level of resistance, particularly in a scenario where the treatment is successful at the within-host scale.
理解抗菌药物耐药性的流行病学和进化动态是一个主要的公共卫生关注点。在本文中，我们提出了一个嵌套模型，明确地将宿主内和宿主间尺度联系起来，其中细菌种群的耐药水平被视为连续的定量特征。宿主内动态基于耐药水平构建的积分微分方程，而宿主间尺度则由感染后的时间进一步构建。该模型同时捕捉了细菌种群的动态、导致耐药性出现的进化瞬态动态以及宿主种群的流行动态。此外，我们通过进行一致持久性和全局渐近性结果的精确分析来研究所提出的模型。最后，我们讨论了宿主群体治疗率对控制传染病爆发和平均耐药水平的影响，无论是宿主内尺度治疗成功还是失败。我们还探讨了在宿主内尺度治疗成功的情况下，感染人群（治疗和未治疗）之间的转换如何影响平均耐药水平，特别是在这种情况下。
