Theoretical and experimental evidence for eliminating persister bacteria by manipulating killing timing

Abstract

Formation of a transient sub-population of bacteria, referred to as persisters, is one of the most important and least understood mechanisms that bacteria employ to evade elimination. Persister cells appear to be slow-growing bacteria that are broadly protected from a wide range of antibiotics. Using both theoretical and experimental methods, we show that alternating the application and withdrawal of antibiotics can be an effective treatment-as long as the timing of the protocol is estimated with precision. More specifically, we demonstrate that timing the alternating treatment based on theoretical predictions is confirmed using experimental observations. These results support a large class of theoretical studies that show that, even without complete understanding of the biological mechanisms, these models can provide insight into properties of the system.

Keywords: Staphylococcus aureus; biofilm; mathematical modeling; ofloxacin; persister; tolerance.