ArticlePLoS pathogens2019
On the evolutionary ecology of multidrug resistance in bacteria.
Article in PLoS pathogens, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers.
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Who cites it
42 citing papers in PubMed.
- Macrolide and Nonmacrolide Resistance with Mass Azithromycin Distribution.The New England journal of medicine · 2020Trial
- Widespread antibiotic-resistantOne health (Amsterdam, Netherlands) · 2026Article
- Modelling the role of the microbiome in antimicrobial resistance across scales.Nature microbiology · 2026Review
- Evolutionary inference reveals global natural histories and predicted pathways of antimicrobial resistance in Klebsiella pneumoniae.PLoS biology · 2026Article
- Epistasis mediates the role of negative frequency-dependent selection in bacterial strain structure.PLoS computational biology · 2026Article
- Old drugs, new weapons: current trends in repurposing therapies against antimicrobial resistance.Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · 2026Review
- Genomic profiling of ESBL/AmpC-producingFrontiers in microbiology · 2026Article
- Will It Be Possible in the Future to Target Innate Immunity Against Staphylococcus aureus Using Resident Microbiota and Plant Extracts?Journal of immunology research · 2026Article
- Vertical stratification and functional coupling of antibiotic resistance and carbon metabolism in thermokarst lake sediments.ISME communications · 2026Article
- Antimicrobial Activity, Genetic Diversity and Safety Assessment of Lactic Acid Bacteria Isolated from European Hakes (Antibiotics (Basel, Switzerland) · 2025Article
- Disruption ofMicrobiology (Reading, England) · 2025Article
- A Comprehensive Overview of Antibacterial Agents for Combating Multidrug-Resistant Bacteria: The Current Landscape, Development, Future Opportunities, and Challenges.Antibiotics (Basel, Switzerland) · 2025Review
- An Overview of the Genetic Mechanisms of Colistin-Resistance in Bacterial Pathogens: An Indian Perspective.Cureus · 2025Review
- The evolution of antibiotic resistance in Europe, 1998-2019.PLoS pathogens · 2025Article
- Multidrug Resistance ofPathogens (Basel, Switzerland) · 2024Article
- Predicting future hospital antimicrobial resistance prevalence using machine learning.Communications medicine · 2024Article
- Recent approaches in computational modelling for controlling pathogen threats.Life science alliance · 2024Review
- Genetic insights of antibiotic resistance, pathogenicity (virulence) and phylogenetic relationship of Escherichia coli strains isolated from livestock, poultry and their handlers - a one health snapshot.Molecular biology reports · 2024Article
- Global surveillance of antimicrobial resistance in food animals using priority drugs maps.Nature communications · 2024Article
- Estimating the fitness cost and benefit of antimicrobial resistance from pathogen genomic data.Journal of the Royal Society, Interface · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Resistance against different antibiotics appears on the same bacterial strains more often than expected by chance, leading to high frequencies of multidrug resistance. There are multiple explanations for this observation, but these tend to be specific to subsets of antibiotics and/or bacterial species, whereas the trend is pervasive. Here, we consider the question in terms of strain ecology: explaining why resistance to different antibiotics is often seen on the same strain requires an understanding of the competition between strains with different resistance profiles. This work builds on models originally proposed to explain another aspect of strain competition: the stable coexistence of antibiotic sensitivity and resistance observed in a number of bacterial species. We first identify a partial structural similarity in these models: either strain or host population structure stratifies the pathogen population into evolutionarily independent sub-populations and introduces variation in the fitness effect of resistance between these sub-populations, thus creating niches for sensitivity and resistance. We then generalise this unified underlying model to multidrug resistance and show that models with this structure predict high levels of association between resistance to different drugs and high multidrug resistance frequencies. We test predictions from this model in six bacterial datasets and find them to be qualitatively consistent with observed trends. The higher than expected frequencies of multidrug resistance are often interpreted as evidence that these strains are out-competing strains with lower resistance multiplicity. Our work provides an alternative explanation that is compatible with long-term stability in resistance frequencies.
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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.