Resistance diagnostics as a public health tool to combat antibiotic resistance: A model-based evaluation

• DOI: 10.1371/journal.pbio.3000250
• Publication Date: 2019-05-16T17:26:22Z
• Authors: David McAdams; Kristofer Wollein...; Christine Tedijanto; Marc Lipsitch; Sam P. Brown
• Keywords: 0301 basic medicine; 0303 health sciences; 03 medical and health sciences; Streptococcus pneumoniae; QH301-705.5; Point-of-Care Systems; Humans; Drug Resistance, Microbial; Public Health; Biology (General); Models, Theoretical; Research Article; 3. Good health

Rapid point-of-care resistance diagnostics (POC-RD) are a key tool in the fight against antibiotic resistance. By tailoring drug choice to infection genotype, doctors can improve treatment efficacy while limiting costs of inappropriate prescription. Here, we combine epidemiological theory and data assess potential (RD) innovations public health context, as means limit or even reverse selection for POC-RD be used impose nonbiological fitness cost on resistant strains by enabling diagnostic-informed targeted interventions that reduce strains' opportunities transmission. We this diagnostic-imposed context spectrum bacterial population biologies find have greater obligate pathogens than opportunistic already subject under "bystander" exposure during asymptomatic carriage (e.g., pneumococcus). close generalizing notion RD-informed strategies incorporate surveillance information illustrate coupling transmission-control discovery potentially select broad range pathogens.