VIB Center for Microbiology, Flanders Institute for Biotechnology, Leuven, Belgium.
Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium.
mBio. 2019 Sep 10;10(5):e02095-19. doi: 10.1128/mBio.02095-19.
Antibiotic resistance poses an alarming and ever-increasing threat to modern health care. Although the current antibiotic crisis is widely acknowledged, actions taken so far have proved insufficient to slow down the rampant spread of resistant pathogens. Problematically, routine screening methods and strategies to restrict therapy failure almost exclusively focus on genetic resistance, while evidence for dangers posed by other bacterial survival strategies is mounting. Antibiotic tolerance, occurring either population-wide or in a subpopulation of cells, allows bacteria to transiently overcome antibiotic treatment and is overlooked in clinical practice. In addition to prolonging treatment and causing relapsing infections, recent studies have revealed that tolerance also accelerates the emergence of resistance. These critical findings emphasize the need for strategies to combat tolerance, not only to improve treatment of recurrent infections but also to effectively address the problem of antibiotic resistance at the root.
抗生素耐药性对现代医疗保健构成了惊人且日益严重的威胁。尽管当前的抗生素危机已广为人知,但迄今为止采取的行动证明不足以减缓耐药病原体的猖獗传播。有问题的是,常规的筛选方法和限制治疗失败的策略几乎完全集中在遗传耐药性上,而越来越多的证据表明其他细菌生存策略所带来的危险。抗生素耐受性,无论是在整个群体中还是在细胞亚群中,都使细菌能够暂时克服抗生素治疗,而这在临床实践中被忽视了。除了延长治疗时间并导致复发性感染外,最近的研究还揭示了耐受性也会加速耐药性的出现。这些关键发现强调了需要采取策略来对抗耐受性,不仅要改善复发性感染的治疗,还要从根本上有效解决抗生素耐药性问题。