ReviewClinical microbiology reviews2015
Antimicrobial heteroresistance: an emerging field in need of clarity.
Review in Clinical microbiology reviews, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 280 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
280 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Global trends and research profile of antibiotic heteroresistance: a bibliometric and visual analysis.Frontiers in microbiology · 2026Pooled it
- Drug-resistantClinical microbiology reviews · 2025Pooled it
- In search for a synergistic combination against pandrug-resistant A. baumannii; methodological considerations.Infection · 2022Pooled it
- Dual population-level processes contribute to polyclonal ceftiofur heteroresistance in swine-derivedVirulence · 2026Article
- Population size modulates the transition from gene amplification-mediated heteroresistance to stable resistance.npj antimicrobials and resistance · 2026Article
- Transcriptional regulation drives heteroresistance inmSystems · 2026Article
- Beyond antifungal susceptibility: molecular mechanisms, detection, and clinical implications of fungal heteroresistance.Molecular biology reports · 2026Review
- Combinatorial action of regulatory systems generates colistin heteroresistance.Science advances · 2026Article
- Heterogeneity in the response to the metabolic environment drives fosfomycin heteroresistance.Nature communications · 2026Article
- Evaluation of an adapted relative growth method by MALDI-TOF MS for rapid determination of the susceptibility ofMicrobiology spectrum · 2026Article
- Macrolide antibiotic action, resistance, and tolerance, and approaches to improve their activity against Gram-negative bacteria.The Journal of antibiotics · 2026Review
- High prevalence of colistin heteroresistance in Pseudomonas aeruginosa bloodstream isolates and associated clinical factors.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Genomic Characterization of Colistin and Fluoroquinolone Resistance in Multidrug-ResistantAntibiotics (Basel, Switzerland) · 2026Article
- Differential apoptosis of GES-1 cells induced by Helicobacter pylori with heteroresistance to clarithromycin.Archives of microbiology · 2026Article
- Multidrug-Resistant Vibrio spp. carrying carbapenemase genes in aquacultured shrimp and their zoonotic importance.Scientific reports · 2026Article
- Bacterial heteroresistance mechanisms, dynamics, and emerging diagnostic approaches.Bioscience reports · 2026Review
- Beyond susceptibility results: understanding the clinical and diagnostic burden of bacterial heteroresistance.Molecular biology reports · 2026Review
- Beyond minimum inhibitory concentration values: clinical and diagnostic challenges of colistin heteroresistance in Acinetobacter baumannii.Molecular biology reports · 2026Review
- Bacteriophage Heteroresistance as a Cause of Treatment Failure in Urinary Tract Infections.bioRxiv : the preprint server for biology · 2026Article
- Clinical characteristics and temporal trends of meropenem and piperacillin/tazobactam heteroresistance in Pseudomonas aeruginosa isolates.Annals of clinical microbiology and antimicrobials · 2026Article
220 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
"Heteroresistance" describes a phenomenon where subpopulations of seemingly isogenic bacteria exhibit a range of susceptibilities to a particular antibiotic. Unfortunately, a lack of standard methods to determine heteroresistance has led to inappropriate use of this term. Heteroresistance has been recognized since at least 1947 and occurs in Gram-positive and Gram-negative bacteria. Its clinical relevance may be considerable, since more resistant subpopulations may be selected during antimicrobial therapy. However, the use of nonstandard methods to define heteroresistance, which are costly and involve considerable labor and resources, precludes evaluating the clinical magnitude and severity of this phenomenon. We review the available literature on antibiotic heteroresistance and propose recommendations for definitions and determination criteria for heteroresistant bacteria. This will help in assessing the global clinical impact of heteroresistance and developing uniform guidelines for improved therapeutic outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.