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Title: Modeling Neisseria gonorrhoeae resistance to fluoroquinolones and cephalosporins in the United States from 2000-2010: Effects of sex, behavior, and screening practices on resistance
Authors: Bornkamp, Nicole L.
Advisors: Levin, Simon A.
Department: Ecology and Evolutionary Biology
Class Year: 2014
Abstract: In 2013 the CDC decided that multidrug-resistant Neisseria gonorrhoeae, the pathogen causing gonorrhea is ‘an immediate public health threat that requires urgent and aggressive action.’ Gonorrhea is a sexually transmitted infection that is the second most commonly acquired infectious disease in the United States. Gonorrhea is curable through antibiotic treatment, yet the bacteria have exhibited an extraordinary ability to acquire and propagate resistance. The bacteria have effectively become resistant to every known drug class except for cephalosporins, the currently recommended first-line therapy treatment. However, evidence of resistance to cephalosporins has appeared in Asia, Europe, and most recently, the United States. This study presents two theoretical models to analyze the drivers of Gonococcal infectivity and resistance in the United States from 2000-2010. The models presented in this work will utilize a unique schematic, breaking down the infected classes to represent wildtype, drug-resistant, and multidrug-resistant strains. They utilize a deterministic, SIS framework to analyze four different susceptible populations: core females, core males, noncore females, and noncore males. The first model will examine the proportions of individuals in each infected class to determine the populations primarily responsible for driving infection and resistance. The second model introduces screening into these subpopulations most responsible for infection and resistance to test the effect that increased treatment has on overall resistance. The results of the first model suggest that core sexual activity members are most responsible for the propagation of infection and resistance. The results of the second model support the hypothesis that introducing screening would increase overall resistance in the population from the increased use of antibiotics. If the population, specifically core group individuals, is not targeted for adequate and specific control measures, the United States may enter into a post-antibiotic era for gonorrhea.
Extent: 111 pages
Type of Material: Princeton University Senior Theses
Language: en_US
Appears in Collections:Ecology and Evolutionary Biology, 1992-2017

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