ArticleNature communications2021
Rapid evolution and host immunity drive the rise and fall of carbapenem resistance during an acute Pseudomonas aeruginosa infection.
Article in Nature communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers.
What it found
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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.
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Who cites it
52 citing papers in PubMed, 76 citations in OpenAlex.
- Simulating the host niche: balancing complexity and control in the experimental evolution of antibiotic resistance and pathoadaptation.Microbiology (Reading, England) · 2026Review
- Climate change and antimicrobial resistance.Nature reviews. Microbiology · 2026Review
- Microbial interactions as key players shaping the emergence and spread ofMicrobiology (Reading, England) · 2026Review
- Beyond Resistance Genes:Life (Basel, Switzerland) · 2026Review
- Resistance potentiators: Evolutionary catalysts of antibiotic resistance.PLoS biology · 2026Article
- Macrophage-mediated antibiotic evasion and competitive dominance of mcr-3-carrying Escherichia coli.PLoS pathogens · 2026Article
- Beyond resistance and tolerance: rethinking evolutionary responses to antibiotics from the perspective of individual bacterial cells.Nature communications · 2026Review
- Surveillance of carbapenem-resistant Pseudomonas aeruginosa isolates obtained from patients treated in a paediatric hospital in Mexico.Scientific reports · 2026Article
- Forecasting Multitrait Resistance Evolution under Antibiotic Stress.Molecular biology and evolution · 2026Article
- A Concept Using α-Niche Evolution Within Bacterial Communities to Direct β-Niche Evolution of Focal Species.Environmental microbiology · 2026Article
- Bile acid metabolism dysregulation following Helicobacter pylori eradication promotes plasmid-mediated antimicrobial resistance in the gut microbiome.The ISME journal · 2026Article
- "Super Sandwich" Assay Using Phenylboronic Acid for the Detection ofMicroorganisms · 2025Article
- Pseudomonas aeruginosa: ecology, evolution, pathogenesis and antimicrobial susceptibility.Nature reviews. Microbiology · 2025Review
- Bacterial immune systems as causes and consequences of microbiome structure.PLoS biology · 2025Article
- A multi-hospital, clinician-initiated bacterial genomics programme to investigate treatment failure in severe Staphylococcus aureus infections.Nature communications · 2025Article
- A Selective Chromogenic Medium for Detecting Meropenem-ResistantAntibiotics (Basel, Switzerland) · 2025Article
- Genomics for antimicrobial resistance-progress and future directions.Antimicrobial agents and chemotherapy · 2025Review
- Beta-Lactam Antibiotic Concentrations and the Acquisition of Multi-Drug Resistant Bacteria in Critically Ill Patients.Life (Basel, Switzerland) · 2025Article
- Interplay between porin deficiency, fitness, and virulence in carbapenem-non-susceptible Pseudomonas aeruginosa and Enterobacteriaceae.PLoS pathogens · 2025Review
- Harnessing the human gut microbiota: an emerging frontier in combatting multidrug-resistant bacteria.Frontiers in immunology · 2025Review
Corrections and comments
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Authors and funding
26 authors at 7 institutions in 5 countries.
Funding
Abstract
It is well established that antibiotic treatment selects for resistance, but the dynamics of this process during infections are poorly understood. Here we map the responses of Pseudomonas aeruginosa to treatment in high definition during a lung infection of a single ICU patient. Host immunity and antibiotic therapy with meropenem suppressed P. aeruginosa, but a second wave of infection emerged due to the growth of oprD and wbpM meropenem resistant mutants that evolved in situ. Selection then led to a loss of resistance by decreasing the prevalence of low fitness oprD mutants, increasing the frequency of high fitness mutants lacking the MexAB-OprM efflux pump, and decreasing the copy number of a multidrug resistance plasmid. Ultimately, host immunity suppressed wbpM mutants with high meropenem resistance and fitness. Our study highlights how natural selection and host immunity interact to drive both the rapid rise, and fall, of resistance during infection.
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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.