论文标题
抗生素治疗，传染性持续时间和疾病传播
Antibiotic treatment, duration of infectiousness, and disease transmission
论文作者
论文摘要
人类，家畜，果园作物和观赏植物通常会因细菌感染而接受抗生素治疗。通过治愈感染性个体，抗生素疗法可能会限制传染性疾病在宿主之间的传播。但是，抗生素对宿主病原体密度的抑制也可能降低宿主在治疗恢复之前从传染状态中删除的可能性。当通过治疗和其他切除事件（例如隔离或死亡率）恢复率直接取决于宿主病原体密度时，抗生素治疗可以充分放松总体去除率，从而增加宿主疾病传播之间。为了探索这种依赖性，确定性的内部动力学驱动了感染性宿主的时间依赖性疾病传播的可能性，以及传染时期的概率持续时间。在宿主内部量表上，模型变化（1）接种物大小，（2）细菌自我调节，（3）感染和治疗开始之间的时间，以及（4）抗生素疗效。在主机间尺度上，模型变化（5）传染性宿主随机遇到的组的大小/敏感性。结果确定了抗生素治疗可以增加宿主传染性持续时间的条件，从而增加了预期的新感染数量。在较低的抗生素功效下，治疗可能会将一种罕见的严重细菌疾病转化为一种常见但可治疗的感染。
Humans, domestic animals, orchard crops, and ornamental plants are commonly treated with antibiotics in response to bacterial infection. By curing infectious individuals, antibiotic therapy might limit the spread of contagious disease among hosts. But an antibiotic`s suppression of within-host pathogen density might also reduce the probability that the host is otherwise removed from infectious status prior to therapeutic recovery. When rates of both recovery via treatment and other removal events (e.g., isolation or mortality) depend directly on within-host pathogen density, antibiotic treatment can relax the overall removal rate sufficiently to increase between-host disease transmission. To explore this dependence, a deterministic within-host dynamics drives the infectious host's time-dependent probability of disease transmission, as well as the probabilistic duration of the infectious period. At the within-host scale, the model varies (1) inoculum size, (2) bacterial self-regulation, (3) the time between infection and initiation of therapy, and (4) antibiotic efficacy. At the between-host scale the model varies (5) the size/susceptibility of groups randomly encountered by an infectious host. Results identify conditions where antibiotic treatment can increase duration of a host`s infectiousness, and consequently increase the expected number of new infections. At lower antibiotic efficacy, treatment might convert a rare, serious bacterial disease into a common, but treatable infection.
