Understanding the evolution of multiple drug resistance in structured populations

Abstract
Data availability
Article and author information
Metrics

Abstract

The evolution of multidrug resistance (MDR) is a pressing public health concern. Yet many aspects, such as the role played by population structure, remain poorly understood. Here we argue that studying MDR evolution by focusing upon the dynamical equations for linkage disequilibrium (LD) can greatly simplify the calculations, generate more insight, and provide a unified framework for understanding the role of population structure. We demonstrate how a general epidemiological model of MDR evolution can be recast in terms of the LD equations. These equations reveal how the different forces generating and propagating LD operate in a dynamical setting at both the population and metapopulation levels. We then apply these insights to show how the LD perspective: (i) explains equilibrium patterns of MDR, (ii) provides a simple interpretative framework for transient evolutionary dynamics, and (iii) can be used to assess the consequences of different drug prescription strategies for MDR evolution.

Data availability

All data used was from a previously published study (Lehtinen et al. 2019 PLoS Pathogens and Turner et al. 2012 PLoS ONE); this data has been uploaded by those authors to a public repository, we downloaded it from there and have provided the details.

The following previously published data sets were used

1. Lehtinen et al.
(2019) S1 File. Resistance profiles and duration of carriage estimates for the Maela dataset.
PLoS Pathogens.

https://doi.org/10.1371/journal.ppat.1007763.s002

Article and author information

Author details

David V McLeod

Ecologie Evolutive et Comportementale, CEFE - CNRS, Montpellier, France

For correspondence
david.mcleod@cefe.cnrs.fr

Competing interests
The authors declare that no competing interests exist.

"This ORCID iD identifies the author of this article:" 0000-0003-2551-7877
Sylvain Gandon

CEFE, CEFE - CNRS, Montpellier, France

For correspondence
sylvain.gandon@cefe.cnrs.fr

Competing interests
The authors declare that no competing interests exist.

Funding

Natural Sciences and Engineering Research Council of Canada (Postdoctoral fellowship)

David V McLeod

Agence Nationale de la Recherche (ANR-17-CE35-0012)

Sylvain Gandon

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Copyright

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.