Modelling Approaches to Guide Intelligent surveillance for the sustainable Introduction of Novel ANtibiotics (MAGIcIAN)

Due to rapidly increasing antimicrobial resistance (AMR) worldwide, our current arsenal of antibiotics is becoming less and less effective in treating bacterial infections. After new antibiotics are introduced, bacteria quickly develop resistance against them. As a result, the return on investment in new antibiotics is minimal and their supply is scarce. A sustainable introduction is only possible if it is accompanied by a timely and well-informed surveillance of resistance. Affordable and effective methods are urgently needed to address the problem of antimicrobial resistance at national and local levels. The MAGIcIAN project aims to meet that need.

Methods

The MAGIcIAN consortium developed models and methods to prioritise surveillance activities globally. Firstly, researchers linked existing information on AMR at national and sub-national levels with different socio-economic, demographic, geographic and climatic datasets using statistical analysis and machine learning algorithms. Secondly, by integrating a dynamic sexual network model with transmission and infection dynamics and different prevention, screening, and surveillance policies, they have provided a simulation environment that allows the analysis of epidemic evolution and AMR dynamics, including the implementation of different scenarios of health interventions.

Results

During the project the researchers have produced several models which are now available for modelling studies. At the larger, global and national scale, they developed statistical, data science type models that successfully linked socioeconomic and demographic characteristics of countries to expected AMR rates. As such, the approach can be used to prioritise surveillance activities in settings where infrastructure and monetary means are limited. The within-host, between-host and integrated models are being developed further to aid in developing stewardship and surveillance strategies for the introduction of zoliflodacin in selected low- and middle-income countries in collaboration with GARDP.