Heteroresistance to beta-lactam antibiotics may often be a stage in the progression to antibiotic resistance.

Heteroresistance to beta-lactam antibiotics may often be a stage in the progression to antibiotic resistance.

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Antibiotic resistance is a growing crisis that threatens many aspects of modern healthcare.Dogma is that resistance often develops due to acquisition of a resistance gene or mutation and that when this occurs, all the cells in the bacterial population are phenotypically resistant.In contrast, heteroresistance (HR) is a form of antibiotic resistance where only a subset of cells within a bacterial population are resistant 70 x 70 tablecloth to a given drug.

These resistant cells can rapidly replicate in the presence of the antibiotic and cause treatment failures.If and how HR and resistance are related is unclear.Using carbapenem-resistant Enterobacterales (CRE), we provide evidence that HR to beta-lactams develops over years of antibiotic usage and that it is gradually supplanted by resistance.

This suggests trucf the possibility that HR may often develop before resistance and frequently be a stage in its progression, potentially representing a major shift in our understanding of the evolution of antibiotic resistance.