Assessing the Impact of Mutations and Horizontal Gene Transfer on the AMR Control: A Mathematical Model

Abstract: Antimicrobial resistance (AMR) poses a significant threat to public health by increasing mortality, extending hospital stays, and increasing healthcare costs. It affects people of all ages and affects health services, veterinary medicine, and agriculture, making it a pressing global issue. Mathematical models are required to predict the behaviour of AMR and to develop control measures to eliminate resistant bacteria or reduce their prevalence. This study presents a simple deterministic mathematical model in which sensitive and resistant bacteria interact in the environment, and mobile genetic elements (MGEs) are functions that depend on resistant bacteria. We analyze the qualitative properties of the model and propose an optimal control problem in which avoiding mutations and horizontal gene transfer (HGT) are the primary control strategies. We also provide a case study of the resistance and multidrug resistance (MDR) percentages of Escherichia coli to gentamicin and amoxicillin in some European countries using data from the European Antimicrobial Resistance Surveillance Network (EARS-Net). Our theoretical results and numerical experiments indicate that controlling the spread of resistance in southern European regions through the supply of amoxicillin is challenging. However, the host immune system is also critical for controlling AMR.