Reinforcement learning informs optimal treatment strategies to limit antibiotic resistance

Antimicrobial resistance was estimated to be associated with 4.95 million deaths worldwide in 2019. It is possible to frame the antimicrobial resistance problem as a feedback-control problem. If we could optimize this feedback-control problem and translate our findings to the clinic, we could slow, prevent, or reverse the development of high-level drug resistance. Prior work on this topic has relied on systems where the exact dynamics and parameters were known a priori. In this study, we extend this work using a reinforcement learning (RL) approach capable of learning effective drug cycling policies in a system defined by empirically measured fitness landscapes. Crucially, we show that it is possible to learn effective drug cycling policies despite the problems of noisy, limited, or delayed measurement. Given access to a panel of 15 [Formula: see text]-lactam antibiotics with which to treat the simulated Escherichia coli population, we demonstrate that RL agents outperform two naive treatment paradigms at minimizing the population fitness over time. We also show that RL agents approach the performance of the optimal drug cycling policy. Even when stochastic noise is introduced to the measurements of population fitness, we show that RL agents are capable of maintaining evolving populations at lower growth rates compared to controls. We further tested our approach in arbitrary fitness landscapes of up to 1,024 genotypes. We show that minimization of population fitness using drug cycles is not limited by increasing genome size. Our work represents a proof-of-concept for using AI to control complex evolutionary processes.

Errataetall:

UpdateOf: bioRxiv. 2023 Nov 16;:. - PMID 36711676

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:121

Enthalten in:

Proceedings of the National Academy of Sciences of the United States of America - 121(2024), 16 vom: 16. Apr., Seite e2303165121

Sprache:

Englisch

Beteiligte Personen:

Weaver, Davis T [VerfasserIn]
King, Eshan S [VerfasserIn]
Maltas, Jeff [VerfasserIn]
Scott, Jacob G [VerfasserIn]

Links:

Volltext

Themen:

Anti-Infective Agents
Antibiotic resistance
Artificial intelligence
Evolution
Journal Article

Anmerkungen:

Date Completed 15.04.2024

Date Revised 29.04.2024

published: Print-Electronic

UpdateOf: bioRxiv. 2023 Nov 16;:. - PMID 36711676

Citation Status MEDLINE

doi:

10.1073/pnas.2303165121

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370972449