Abstract
Bacteria are well known for their extremely high adaptability in stressful environments. The clinical relevance of this property is clearly illustrated by the ever-decreasing efficacy of antibiotic therapies. Frequent exposures to antibiotics favor bacterial strains that have acquired mechanisms to overcome drug inhibition and lethality. Many strains, including life-threatening pathogens, exhibit increased antibiotic resistance or tolerance, which considerably complicates clinical practice. Alarmingly, recent studies show that in addition to resistance, tolerance levels of bacterial populations are extremely flexible in an evolutionary context. Here, we summarize laboratory studies providing insight in the evolution of resistance and tolerance and shed light on how the treatment conditions could affect the direction of bacterial evolution under antibiotic stress.
Highlights
Bacterial populations can adopt different strategies to become refractory to an antibiotic treatment that would otherwise be lethal
A well-documented antibiotic survival strategy is resistance, which is usually conferred by genetic changes that allow bacteria to grow at elevated drug concentrations
Resistance is routinely quantified by the minimum inhibitory concentration (MIC), defined as the lowest antibiotic concentration that is required to prevent bacterial growth [1]
Summary
Bacteria are well known for their extremely high adaptability in stressful environments. Frequent exposures to antibiotics favor bacterial strains that have acquired mechanisms to overcome drug inhibition and lethality. Many strains, including life-threatening pathogens, exhibit increased antibiotic resistance or tolerance, which considerably complicates clinical practice. Recent studies show that in addition to resistance, tolerance levels of bacterial populations are extremely flexible in an evolutionary context. We summarize laboratory studies providing insight in the evolution of resistance and tolerance and shed light on how the treatment conditions could affect the direction of bacterial evolution under antibiotic stress
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