ResisTrack project - Tackling antimicrobial resistance in hospitals: a holistic eco-evolutionary model of resistance gene dissemination to optimize intervention strategies

Antimicrobial resistance (AMR) of pathogenic bacteria increases at an alarming rate worldwide. To combat AMR in hospital by designing efficient antibiotic stewardship and infection control (AS/IC) strategies, we should improve our knowledge of how the interplay of microbiological and environmental factors influences the emergence and spread of resistance in the hospital.

The main goal of the ResisTrack project is to investigate an array of candidate AS/IC interventions to identify optimal strategies and understand how antimicrobial resistance genes (ARGs) emerge and spread in hospitals. Building upon recent advances in ecology and systems biology, the ResisTrack project will construct and calibrate an integrative ecological and evolutionary model of resistance dynamics building on a multiscale model including the dissemination of ARGs, mobile genetic elements (MGEs), bacteria and patients.

The project has four objectives :

- (1) to construct an eco-evolutionary simulation system of hospital AMR based on a mechanistic, holistic model of vertical and horizontal transfer of ARGs in a hospital network

- (2) to integrate modifiable factors into the model to mimic AS/IC interventions including modifications of patient movements and antibiotic treatments

- (3) to calibrate model parameters with microbiological and treatment data from a 5,400-bed university hospital group (HCL) over 5 years, as well as with genomic information (whole-genome sequences) of 1,600 non-redundant bacterial isolates

- (4) to represent AS/IC interventions in the calibrated simulation model to identify optimal interventions against AMR