Details

Autor(en) / Beteiligte

• Dewachter, Liselot
• Fauvart, Maarten
• Michiels, Jan

Titel

Bacterial Heterogeneity and Antibiotic Survival: Understanding and Combatting Persistence and Heteroresistance

Ist Teil von

• Molecular cell, 2019-10, Vol.76 (2), p.255-267

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2019

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• For decades, mankind has dominated the battle against bacteria, yet the tide is slowly turning. Our antibacterial strategies are becoming less effective, allowing bacteria to get the upper hand. The alarming rise in antibiotic resistance is an important cause of anti-infective therapy failure. However, other factors are at play as well. It is widely recognized that bacterial populations display high levels of heterogeneity. Population heterogeneity generates phenotypes specialized in surviving antibiotic attacks. Nonetheless, the presence of antibiotic-insensitive subpopulations is not considered when initiating treatment. It is therefore time to reevaluate how we combat bacterial infections. We here focus on antibiotic persistence and heteroresistance, phenomena in which small fractions of the population are tolerant (persisters) and resistant to antibiotics, respectively. We discuss molecular mechanisms involved, their clinical importance, and possible therapeutic strategies. Moving forward, we argue that these heterogeneous phenotypes should no longer be ignored in clinical practice and that better diagnostic and therapeutic approaches are urgently needed. [Display omitted] Population heterogeneity generates phenotypes specialized in surviving antibiotic attacks. Persistence and heteroresistance are examples of such heterogeneity that can lead to treatment failure. However, the presence of antibiotic-insensitive subpopulations is not considered when initiating treatment. We here discuss the molecular mechanisms involved in these phenomena, their clinical importance, and possible therapeutic strategies.