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Updated: Sep 30, 2025
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Testing the Role of Multicopy Plasmids in the Evolution of Antibiotic Resistance
Published on: May 2, 2018
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Does plasmid-based beta-lactam resistance increase E. coli infections: Modelling addition and replacement mechanisms
Noortje G Godijk1, Martin C J Bootsma1,2, Henri C van Werkhoven1
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Plos Computational Biology
|March 14, 2022
Summary
Antibiotic-resistant infections may not increase overall infection rates. Mathematical modeling suggests resistant strains often replace susceptible ones, except when virulence increases, indicating disease burden stems from resistance effects, not higher infection incidence.
Area of Science:
- Microbiology
- Epidemiology
- Mathematical Biology
Background:
- Antibiotic resistance is a growing global health concern.
- The impact of antibiotic-resistant infections on overall infection incidence remains unclear.
- Distinguishing between addition and replacement of infections is crucial for understanding disease burden.
Purpose of the Study:
- To investigate whether antibiotic-resistant infections add to or replace antibiotic-susceptible infections.
- To model the effects of various biological mechanisms on infection dynamics.
- To determine factors influencing total infection incidence.
Main Methods:
- Utilized mathematical modeling with a neutral null model.
- Simulated plasmid-based beta-lactam resistant E. coli.
- Analyzed seven distinct biological mechanisms, including fitness costs and resistance benefits.
Main Results:
- Fitness costs led to the extinction of resistant strains.
- Increased virulence was the sole mechanism that increased total infection numbers.
- Other resistance benefits resulted in the replacement of susceptible infections without altering total incidence.
Conclusions:
- Antibiotic resistance does not necessarily increase the total number of infections.
- Disease burden is primarily driven by the attributable effects of resistance, not an increase in infection incidence.
- Increased virulence is the only modeled factor that elevates overall infection counts.
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