ArticleJournal of the Royal Society, Interface2010
What is the mechanism for persistent coexistence of drug-susceptible and drug-resistant strains of Streptococcus pneumoniae?
Article in Journal of the Royal Society, Interface, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers.
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Who cites it
57 citing papers in PubMed.
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- Assessing the effect of social contact structure on the impact of pneumococcal conjugate vaccines.Scientific reports · 2025Article
- Quantifying the effects of antibiotic resistance and within-host competition on strain fitness in Streptococcus pneumoniae.PLoS biology · 2025Article
- Modelling the Epidemiological Impact of Different Adult Pneumococcal Vaccination Strategies in the United Kingdom.Infectious diseases and therapy · 2025Article
- The evolution of antibiotic resistance in Europe, 1998-2019.PLoS pathogens · 2025Article
- Recent approaches in computational modelling for controlling pathogen threats.Life science alliance · 2024Review
- When does antimicrobial resistance increase bacterial fitness? Effects of dosing, social interactions, and frequency dependence on the benefits of AmpCEvolution letters · 2024Article
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- Evidence for sweep signatures in antibiotic-resistant strains in three species of bacteria.PeerJ · 2024Article
- Challenges in Forecasting Antimicrobial Resistance.Emerging infectious diseases · 2023Review
- [The new 15-valent pneumococcal conjugate vaccine for the prevention ofJournal of preventive medicine and hygiene · 2023Article
- The potential of genomics for infectious disease forecasting.Nature microbiology · 2022Review
- Epidemiological dynamics of bacteriocin competition and antibiotic resistance.Proceedings. Biological sciences · 2022Article
- Does plasmid-based beta-lactam resistance increase E. coli infections: Modelling addition and replacement mechanisms.PLoS computational biology · 2022Article
- A stochastic model explains the periodicity phenomenon of influenza on network.Scientific reports · 2021Article
- Evolutionary mechanisms that determine which bacterial genes are carried on plasmids.Evolution letters · 2021Article
- Article
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Authors and funding
8 authors.
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Abstract
The rise of antimicrobial resistance in many pathogens presents a major challenge to the treatment and control of infectious diseases. Furthermore, the observation that drug-resistant strains have risen to substantial prevalence but have not replaced drug-susceptible strains despite continuing (and even growing) selective pressure by antimicrobial use presents an important problem for those who study the dynamics of infectious diseases. While simple competition models predict the exclusion of one strain in favour of whichever is 'fitter', or has a higher reproduction number, we argue that in the case of Streptococcus pneumoniae there has been persistent coexistence of drug-sensitive and drug-resistant strains, with neither approaching 100 per cent prevalence. We have previously proposed that models seeking to understand the origins of coexistence should not incorporate implicit mechanisms that build in stable coexistence 'for free'. Here, we construct a series of such 'structurally neutral' models that incorporate various features of bacterial spread and host heterogeneity that have been proposed as mechanisms that may promote coexistence. We ask to what extent coexistence is a typical outcome in each. We find that while coexistence is possible in each of the models we consider, it is relatively rare, with two exceptions: (i) allowing simultaneous dual transmission of sensitive and resistant strains lets coexistence become a typical outcome, as does (ii) modelling each strain as competing more strongly with itself than with the other strain, i.e. self-immunity greater than cross-immunity. We conclude that while treatment and contact heterogeneity can promote coexistence to some extent, the in-host interactions between strains, particularly the interplay between coinfection, multiple infection and immunity, play a crucial role in the long-term population dynamics of pathogens with drug resistance.
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