Landscape models of AMR refugia and the impact on the evolution of resistance

Supervisors:

Prof Louise Matthews, School of Biodiversity, One Health & Veterinary Medicine
Dr Jess Enright, School of Computing Science

Summary:

Antimicrobial resistance (AMR) is a global issue which is characterised by substantial variation in prevalences of resistance across different countries and settings, such healthcare, agriculture, the community and the environment, also by co-existence of drug-sensitive and drug-resistant strains. Refugia—environments where sensitive strains survive without antibiotic pressure—play a key role in mitigating AMR. However, practical knowledge of refugia at large scales remains limited. One significant resistance type, extended-spectrum beta-lactamase (ESBL), emerged in the 1980s, spread to community infections by the 1990s, and became endemic by the 2000s. ESBL-producing E. coli is now prevalent worldwide, with heterogeneity observed across high- and low-income countries, healthcare, and community settings, as well as coexistence of sensitive and resistant strains. Focusing on E. coli, this project will develop agent-based models to explore the evolution of bacterial resistance. The model will account for infection dynamics, horizontal transmission, and refugia, at multiple spatial scales. The outcome of the project will be an improved understanding of how refugia impact the rate of evolution and how they can be better exploited to reduce the spread of antimicrobial resistance.