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Antimicrobial resistant infections arise as a consequential response to evolutionary mechanisms within microbes which cause them to be protected from the effects of antimicrobials. The frequent occurrence of resistant infections poses a global public health threat as their control has become challenging despite many efforts. The dynamics of such infections are driven by processes at multiple levels. For a long time, mathematical models have proved valuable for unravelling complex mechanisms in the dynamics of infections. In this thesis, we focus on mathematical approaches to modelling the development and spread of resistant infections at between-host (population-wide) and within-host (individual) levels.
Within an individual host, switching between treatments has been identified as one of the methods that can be employed for the gradual eradication of resistant strains on the long term. With this as motivation, we study the problem using dynamical systems and notions from control theory. We present a model based on deterministic logistic differential equations which capture the general dynamics of microbial resistance inside an individual host. Fundamentally, this model describes the spread of resistant infections whilst accounting for evolutionary mutations observed in resistant pathogens and capturing them in mutation matrices. We extend this model to explore the implications of therapy switching from a control theoretic perspective by using switched systems and developing control strategies with the goal of reducing the appearance of drug resistant pathogens within the host.
At the between-host level, we use compartmental models to describe the transmission of infection between multiple individuals in a population. In particular, we make a case study of the evolution and spread of the novel coronavirus (SARS-CoV-2) pandemic. So far, vaccination remains a critical component in the eventual solution to this public health crisis. However, as with many other pathogens, vaccine resistant variants of the virus have been a major concern in control efforts by governments and all stakeholders. Using network theory, we investigate the spread and transmission of the disease on social networks by compartmentalising and studying the progression of the disease in each compartment, considering both the original virus strain and one of its highly transmissible vaccine-resistant mutant strains. We investigate these dynamics in the presence of vaccinations and other interventions. Although vaccinations are of absolute importance during viral outbreaks, resistant variants coupled with population hesitancy towards vaccination can lead to further spread of the virus.