Department of Microbiology, Hospital Universitario Ramon y Cajal (IRYCIS) and Network Research Centre for Epidemiology and Public Health (CIBERESP), 28034, Madrid, Spain.
Trends Microbiol. 2018 Dec;26(12):978-985. doi: 10.1016/j.tim.2018.06.007. Epub 2018 Jul 23.
Antibiotic-resistant infections are an urgent problem in clinical settings because they sharply increase mortality risk in critically ill patients. The horizontal spread of antibiotic resistance genes among bacteria is driven by bacterial plasmids, promoting the evolution of resistance. Crucially, particular associations exist between resistance plasmids and bacterial clones that become especially successful in clinical settings. However, the factors underlying the success of these associations remain unknown. Recent in vitro evidence reveals (i) that plasmids produce fitness costs in bacteria, and (ii) that these costs are alleviated over time through compensatory mutations. I argue that plasmid-imposed costs and subsequent compensatory adaptation may determine the success of associations between plasmids and bacteria in clinical settings, shaping the in vivo evolution of antibiotic resistance.
抗生素耐药性感染是临床环境中的一个紧迫问题，因为它们会显著增加危重病患者的死亡风险。细菌中的抗生素耐药基因的水平传播是由细菌质粒驱动的，促进了耐药性的进化。至关重要的是，耐药质粒与在临床环境中特别成功的细菌克隆之间存在特定的关联。然而，这些关联成功的背后因素尚不清楚。最近的体外证据表明：(i) 质粒会给细菌带来适应性成本，以及 (ii) 这些成本会随着时间的推移通过补偿性突变得到缓解。我认为，质粒带来的成本和随后的适应性补偿可能决定了质粒与细菌在临床环境中的关联的成功程度，从而影响抗生素耐药性的体内进化。
