Modelling the effect of a dengue vaccine on reducing the evolution of resistance against antibiotic due to misuse in dengue cases

Ana Kurauchi,Annelies Wilder-Smith,Claudio Jose Struchiner,Eduardo Massad

doi:10.1186/s12976-020-00125-8

Abstract

BackgroundThis paper intends to check whether and how a hypothetical dengue vaccine could contribute to issue of evolution of bacteria resistance against antibiotics by reducing the number of patients that would inappropriately being treated with antibiotics.MethodsWe use a new mathematical model that combines, in a novel way, two previously published papers, one on the evolution of resistance against antibiotics and one classical Ross-Macdonald model for dengue transmission.ResultsThe model is simulated numerically and reproduces a real case of evolution of resistance against antibiotics. In addition the model shows that the use of a hypothetical dengue vaccine could help to curb the evolution of resistance against an antibiotic inappropriately used in dengue patients. Both the increase in the proportion of resistant bacteria due to the misuse of antibiotics in dengue cases as a function of the fraction of treated patients and the reduction of that proportion as a function of vaccination coverage occur in a highly non-linear fashion.ConclusionThe use of a dengue vaccine is helpful in reducing the rate of evolution of antibiotic resistance in a scenario of misuse of the antibiotics in dengue patients.

Highlights

This paper intends to investigate whether and how a hypothetical dengue vaccine could contribute to issue of evolution of bacteria resistance against antibiotics by reducing the number of patients that would inappropriately being treated with antibiotics
The complete model (1) was simulated with variables and parameters as in Table 1 in order to estimate the impact of inappropriately treating dengue patients with the antibiotics and the impact of vaccination against dengue on the evolution of antibiotic resistance of dengue-infected individuals mistreated with the same antibiotic (Amikacin) against the same pathogen (Klebsiella pneumoniae)
In this paper we propose a composite model to test the hypothesis that a hypothetical vaccine against dengue could help to hamper the evolution of resistance against antibiotics due to their misuse in dengue patients

Summary

Results

Model (1) was simulated, first with the antibiotic resistant component only in order to reproduce the results obtained by Massad, Yang and Lundberg [25] with the data from Klebsiella pneumoniae strains resistant against the antibiotic Amikacin in the Clinics Hospital of the School of Medicine of the University of São Paulo, Brazil. Note that the model tallies the actual data with good accuracy for a fraction of antibiotic treated individuals of 70%. The complete model (1) was simulated with variables and parameters as in Table 1 in order to estimate the impact of inappropriately treating dengue patients with the antibiotics and the impact of vaccination against dengue on the evolution of antibiotic resistance of dengue-infected individuals mistreated with the same antibiotic (Amikacin) against the same pathogen (Klebsiella pneumoniae). Note that the vaccination coverage necessary to reduce the resistance against the antibiotic in this extreme situation is very high

Background

Discussion