ArticleInfectious Disease Modelling2027
Structural transition in antimicrobial resistance dynamics of
Article in Infectious Disease Modelling, 2027. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Antimicrobial resistance (AMR) is typically interpreted as a process of gradual accumulation of resistance traits. However, resistance systems may instead undergo structural transitions under changing selective pressures. We investigated whether long-term AMR dynamics in Methods: Longitudinal resistance data (2013-2025) were analyzed using segmented regression, multinomial modeling, entropy-based diversity metrics, and Markov transition analysis to characterize temporal dynamics, architecture distributions, and system-level behavior. Results: A significant structural breakpoint was identified around 2020 (Davies' test p < 0.001). The estimated breakpoint location showed limited uncertainty based on model-based confidence interval estimation. Prior to 2020, aminoglycoside-containing resistance architectures were prevalent, whereas after 2020 they collapsed and were replaced by aminoglycoside-negative, fluoroquinolone-associated configurations. Phenotypic diversity declined significantly over time, indicating contraction of the resistance state space. Markov analysis demonstrated convergence toward a stable stationary distribution dominated by two related architectures, with increased dynamical stability after the breakpoint. Conclusions: AMR dynamics in
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