Resistance diagnostics as a public health tool to combat antibiotic resistance: A model-based evaluation - Fig 1

Schematic of the obligate/SIS (A, B) and opportunistic/SCIS (C) epidemiological models. Boxes denote proportions of hosts in mutually exclusive states: S for uninfected (susceptible) hosts, I₀ for hosts infected with a strain sensitive to both drugs, and I₁, I₂, and I₁₂ for hosts infected with strains resistant to drugs 1, 2, or both 1 and 2, respectively. In the SCIS model (C, showing only 2 pathogen genotypes for clarity), C₀ and C₁ denote asymptomatic carriage of sensitive and drug 1–resistant bacteria, respectively, and d is the rate at which disease develops from carriage (when d→∞, we recover an SIS model). Box colors denote distinct clinical presentations in the absence (A) or presence (B, C) of multidrug POC-RD. Solid arrows represent flows of individuals between states, and dashed arrows represent factors influencing those flows (e.g., antibiotic treatment). Gray and black arrows denote transmission and clearance, respectively. Equations describing the system are in S1B Text. POC-RD, point-of-care resistance diagnostics; SCIS, Susceptible-Carriage-Infected-Susceptible; SIS, Susceptible-Infected-Susceptible.