Slow spatial migration can help eradicate cooperative antimicrobial resistance in time-varying environments

Antimicrobial resistance (AMR) is a global threat and combating its spread is of paramount importance. AMR often results from cooperative behaviour with shared drug protection. Microbial communities generally evolve in volatile, spatially structured settings. Migration, space, fluctuations, and environmental variability all have a significant impact on the development and proliferation of AMR. While drug resistance is enhanced by migration in static conditions, this changes in time-fluctuating spatially structured environments. Here, we consider a two-dimensional metapopulation consisting of demes where drug-resistant and sensitive cells evolve in a time-changing environment. This contains a toxin against which protection can be shared (cooperative AMR). Cells migrate between demes and connect them. When the environment and the deme composition vary on the same timescale, strong population bottlenecks cause fluctuation-driven extinction events, countered by migration. We investigate the influence of migration and environmental variability on the AMR eco-evolutionary dynamics by asking what migration rate fluctuations can help clear resistance and what are the near-optimal environmental conditions ensuring the quasi-certain eradication of resistance in the shortest possible time. By combining various tools, we answer these questions by determining when the resistant strain goes extinct across the entire metapopulation. While dispersal generally promotes strain coexistence, here we show that slow-but-nonzero migration can speed up and enhance resistance clearance, and determine the near-optimal conditions for this phenomenon. We discuss the impact of our findings on laboratory-controlled experiments and outline their generalisation to lattices of any spatial dimension.