Pneumococcal Competition Modulates Antibiotic Resistance in the Pre-Vaccination Era: A Modelling Study

The ongoing emergence of antibiotic resistant strains and high frequencies of antibiotic resistance of <i>Streptococcus pneumoniae</i> poses a major public health challenge. How and which ecological and evolutionary mechanisms maintain the coexistence of antibiotic resistant and suscepti...

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Main Authors: José Lourenço, Yair Daon, Andrea Gori, Uri Obolski
Format: Article
Language:English
Published: MDPI AG 2021-03-01
Series:Vaccines
Subjects:
Online Access:https://www.mdpi.com/2076-393X/9/3/265
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spelling doaj-5fb8a26081334e7485475385971d13d12021-03-17T00:05:14ZengMDPI AGVaccines2076-393X2021-03-01926526510.3390/vaccines9030265Pneumococcal Competition Modulates Antibiotic Resistance in the Pre-Vaccination Era: A Modelling StudyJosé Lourenço0Yair Daon1Andrea Gori2Uri Obolski3Department of Zoology, University of Oxford, Oxford OX1 3SZ, UKSchool of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelNIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection and Immunity, University College London, London WC1E 6BT, UKSchool of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelThe ongoing emergence of antibiotic resistant strains and high frequencies of antibiotic resistance of <i>Streptococcus pneumoniae</i> poses a major public health challenge. How and which ecological and evolutionary mechanisms maintain the coexistence of antibiotic resistant and susceptible strains remains largely an open question. We developed an individual-based, stochastic model expanding on a previous pneumococci modelling framework. We explore how between- and within-host mechanisms of competition can sustain observed levels of resistance to antibiotics in the pre-vaccination era. Our framework considers that within-host competition for co-colonization between resistant and susceptible strains can arise via pre-existing immunity (immunological competition) or intrinsic fitness differences due to resistance costs (ecological competition). We find that beyond stochasticity, population structure or movement, competition at the within-host level can explain observed resistance frequencies. We compare our simulation results to pneumococcal antibiotic resistance data in the European region using approximate Bayesian computation. Our results demonstrate that ecological competition for co-colonization can explain the variation in co-existence of resistant and susceptible pneumococci observed in the pre-vaccination era. Furthermore, we show that within-host pneumococcal competition can facilitate the maintenance of resistance in the pre-vaccination era. Accounting for these competition-related components of pneumococcal dynamics can improve our understanding of drivers for the emergence and maintenance of antibiotic resistance in pneumococci.https://www.mdpi.com/2076-393X/9/3/265antibiotic resistance<i>Streptococcus pneumoniae</i>ecological competitionimmunological competitionpre-vaccination
collection DOAJ
language English
format Article
sources DOAJ
author José Lourenço
Yair Daon
Andrea Gori
Uri Obolski
spellingShingle José Lourenço
Yair Daon
Andrea Gori
Uri Obolski
Pneumococcal Competition Modulates Antibiotic Resistance in the Pre-Vaccination Era: A Modelling Study
Vaccines
antibiotic resistance
<i>Streptococcus pneumoniae</i>
ecological competition
immunological competition
pre-vaccination
author_facet José Lourenço
Yair Daon
Andrea Gori
Uri Obolski
author_sort José Lourenço
title Pneumococcal Competition Modulates Antibiotic Resistance in the Pre-Vaccination Era: A Modelling Study
title_short Pneumococcal Competition Modulates Antibiotic Resistance in the Pre-Vaccination Era: A Modelling Study
title_full Pneumococcal Competition Modulates Antibiotic Resistance in the Pre-Vaccination Era: A Modelling Study
title_fullStr Pneumococcal Competition Modulates Antibiotic Resistance in the Pre-Vaccination Era: A Modelling Study
title_full_unstemmed Pneumococcal Competition Modulates Antibiotic Resistance in the Pre-Vaccination Era: A Modelling Study
title_sort pneumococcal competition modulates antibiotic resistance in the pre-vaccination era: a modelling study
publisher MDPI AG
series Vaccines
issn 2076-393X
publishDate 2021-03-01
description The ongoing emergence of antibiotic resistant strains and high frequencies of antibiotic resistance of <i>Streptococcus pneumoniae</i> poses a major public health challenge. How and which ecological and evolutionary mechanisms maintain the coexistence of antibiotic resistant and susceptible strains remains largely an open question. We developed an individual-based, stochastic model expanding on a previous pneumococci modelling framework. We explore how between- and within-host mechanisms of competition can sustain observed levels of resistance to antibiotics in the pre-vaccination era. Our framework considers that within-host competition for co-colonization between resistant and susceptible strains can arise via pre-existing immunity (immunological competition) or intrinsic fitness differences due to resistance costs (ecological competition). We find that beyond stochasticity, population structure or movement, competition at the within-host level can explain observed resistance frequencies. We compare our simulation results to pneumococcal antibiotic resistance data in the European region using approximate Bayesian computation. Our results demonstrate that ecological competition for co-colonization can explain the variation in co-existence of resistant and susceptible pneumococci observed in the pre-vaccination era. Furthermore, we show that within-host pneumococcal competition can facilitate the maintenance of resistance in the pre-vaccination era. Accounting for these competition-related components of pneumococcal dynamics can improve our understanding of drivers for the emergence and maintenance of antibiotic resistance in pneumococci.
topic antibiotic resistance
<i>Streptococcus pneumoniae</i>
ecological competition
immunological competition
pre-vaccination
url https://www.mdpi.com/2076-393X/9/3/265
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