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Review
. 2019 Jun 6;15(6):e1007726.
doi: 10.1371/journal.ppat.1007726. eCollection 2019 Jun.

Heteroresistance: A cause of unexplained antibiotic treatment failure?

Victor I Band  1   2 , David S Weiss  1   2   3
Affiliations
Review

Heteroresistance: A cause of unexplained antibiotic treatment failure?

Victor I Band et al. PLoS Pathog. .
No abstract available

PubMed Disclaimer

Conflict of interest statement

I have read the journal's policy and have the following conflicts: patent applications related to heteroresistance.

Figures

Fig 1
Fig 1. Dynamics of heteroresistance during infection and clinical susceptibility testing.
(A) Schematic showing a patient infected with a heteroresistant bacterial isolate harboring a minor subpopulation of antibiotic-resistant cells (red). (B) Clinical susceptibility testing may not detect the minor resistant subpopulation, and the isolate would therefore be incorrectly designated susceptible to the given antibiotic. (C) Subsequent antibiotic therapy selects for the resistant subpopulation, which is able to grow in the presence of the drug. (D) Continued clinical susceptibility testing involves in vitro subculture of the heteroresistant bacteria in the absence of an antibiotic, which leads to a contraction of the resistant subpopulation. This minor subpopulation is therefore still not detected by clinical testing, and the isolate again appears susceptible. (E) Inappropriate antibiotic therapy ultimately leads to treatment failure and inability to clear the infection.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013. Centers for Disease Control and Prevention: Atlanta, GA; 2013. [cited 2018 Dec 11]. Available from: http://www.cdc.gov/drugresistance/threat-report-2013/.
    1. Review on Antimicrobial Resistance. Antimicrobial Resistance: Tackling a Crisis for the Health and Wealth of Nations. London, UK: Review on Antimicrobial Resistance; 2014. [cited 2018 Dec 11]. Available from: https://amr-review.org/Publications.html.
    1. Corona F, Martinez JL. Phenotypic Resistance to Antibiotics. Antibiotics (Basel). 2013;2(2):237–55. Epub 2013/01/01. 10.3390/antibiotics2020237 - DOI - PMC - PubMed
    1. Hjort K, Nicoloff H, Andersson DI. Unstable tandem gene amplification generates heteroresistance (variation in resistance within a population) to colistin in Salmonella enterica. Mol Microbiol. 2016;102(2):274–89. Epub 2016/08/02. 10.1111/mmi.13459 . - DOI - PubMed
    1. Anderson SE, Sherman EX, Weiss DS, Rather PN. Aminoglycoside Heteroresistance in Acinetobacter baumannii AB5075. mSphere. 2018;3(4). Epub 2018/08/15. 10.1128/mSphere.00271-18 - DOI - PMC - PubMed

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