Category: Epidemiology

Summary: Testing whether surveillance delay resonates with behavioral fatigue and horizontal gene transfer to worsen resistance burden in a cycling antibiotic-control model.

Antibiotic cycling strategies aim to slow resistance, but delayed surveillance and declining compliance can interact with gene transfer in nontrivial ways. This experiment asks whether there is a delay-fatigue resonance that produces especially poor outcomes for resistant strains in an ABX-cycle setting.

The code simulates policy schedules with specified cycle periods, surveillance delays, horizontal gene transfer rates, and fatigue rates, then measures resistant-abundance timing, final resistant burden, and cumulative resistance load. It is designed to detect an interaction effect, not just an overall increase or decrease in resistance.

That interaction is important because resistance control often depends on operational timing as much as on drug choice. A resonance regime would imply that modest delays can be disproportionately damaging when combined with behavioral fatigue and genetic exchange.

Method: Repeated antibiotic-cycling simulations with delayed surveillance, compliance fatigue, and horizontal gene transfer, summarized by resistance-burden metrics.

What is measured: Time to resistant-abundance midpoint, final resistant abundance, peak resistant abundance, compliance, switching frequency, resistance-burden area under the curve, and resonance support.