Abstract
Transient resistance can allow microorganisms to temporarily survive lethal concentrations of antibiotics. This can be accomplished through stochastic mechanisms, where individual cells within a population display diverse phenotypes to hedge against the appearance of an antibiotic. To date, research on transient stochastic resistance has focused primarily on mechanisms where a subpopulation of cells enters a dormant, drug-tolerant state. However, a fundamental question is whether stochastic gene expression can also generate variable resistance levels among growing cells in a population. We hypothesized that stochastic expression of antibiotic-inducible resistance mechanisms might play such a role. To investigate this, we focused on a prototypical example of such a system: the multiple antibiotic resistance activator MarA. Previous studies have shown that induction of MarA can lead to a multidrug resistant phenotype at the population level. We asked whether MarA expression also has a stochastic component, even when uninduced. Time lapse microscopy showed that isogenic cells express heterogeneous, dynamic levels of MarA, which were correlated with transient antibiotic survival. This finding has important clinical implications, as stochastic expression of resistance genes may be widespread, allowing populations to hedge against the sudden appearance of an antibiotic.
Highlights
Transient resistance can allow microorganisms to temporarily survive lethal concentrations of antibiotics
In bacterial persistence a small fraction of cells (≤ 1 in 100) called persisters stochastically enter a dormant, drug-tolerant state, allowing the population to hedge against the sudden appearance of an antibiotic[3,4]
It is important to recognize that transient resistance is not caused by genetic changes, rather cells use phenotypic variability or induce gene expression to generate a resistant phenotype[2,3,5,6]
Summary
Transient resistance can allow microorganisms to temporarily survive lethal concentrations of antibiotics This can be accomplished through stochastic mechanisms, where individual cells within a population display diverse phenotypes to hedge against the appearance of an antibiotic. Time lapse microscopy showed that isogenic cells express heterogeneous, dynamic levels of MarA, which were correlated with transient antibiotic survival This finding has important clinical implications, as stochastic expression of resistance genes may be widespread, allowing populations to hedge against the sudden appearance of an antibiotic. Time (mins) extended single-cell lag times can confer transient antibiotic resistance[16,17,18] These mechanisms have the common feature that antibiotic tolerance is achieved by temporarily placing cells in a dormant state
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