ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Prevalence of Antibiotic Tolerance and Risk for Reinfection Among Escherichia coli Bloodstream Isolates: A Prospective Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 25 citations in OpenAlex.
- Bacterial strategies for surviving antibiotics during urinary tract infection: could uropathogenic Escherichia coli be persisters?Nature reviews. Urology · 2026Review
- Heteroresistance tolerance and persistence in antibiotic treatment failure.Folia microbiologica · 2026Review
- Lipid parameters but not inflammatory indices predict hepatitis B vaccine responses in hemodialysis patients.Clinical kidney journal · 2026Article
- Large-scale testing of antimicrobial lethality at single-cell resolution predicts mycobacterial infection outcomes.Nature microbiology · 2026Article
- Antibiotic tolerance and persistence in clinical isolates ofMicrobiology spectrum · 2025Article
- Staphylococcus aureus COL: An Atypical Model Strain of MRSA That Exhibits Slow Growth and Antibiotic Tolerance due to a Mutation in PRPP Synthetase.Molecular microbiology · 2025Article
- Article
- Transcriptomic profiling of ceftriaxone-tolerant phenotypes ofMicrobiology spectrum · 2025Article
- Rapid emergence of resistance to broad-spectrum direct antimicrobial activity of avibactam.Microbiology spectrum · 2025Article
- Ceftazidime-avibactam tolerance and persistence among difficult-to-treat KPC-producing Klebsiella pneumoniae clinical isolates from bloodstream infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Antibiotic tolerance among clinical isolates: mechanisms, detection, prevalence, and significance.Clinical microbiology reviews · 2024Review
- The Prevalence of Antibiotic Tolerance inPathogens (Basel, Switzerland) · 2024Article
- Constitutive Activation of RpoH and the Addition of L-arabinose Influence Antibiotic Sensitivity of PHL628Antibiotics (Basel, Switzerland) · 2024Article
- In-patient evolution of a high-persisterProceedings of the National Academy of Sciences of the United States of America · 2024Article
- Trained immunity in recurrent Staphylococcus aureus infection promotes bacterial persistence.PLoS pathogens · 2024Article
- Disrupting Central Carbon Metabolism Increases β-Lactam Antibiotic Susceptibility in Vibrio cholerae.Journal of bacteriology · 2023Article
- Enolase Is Implicated in the Emergence of Gonococcal Tolerance to Ceftriaxone.Antibiotics (Basel, Switzerland) · 2023Article
- Innovative Strategies to Overcome Antimicrobial Resistance and Tolerance.Microorganisms · 2022Review
- Tolerance to Ceftriaxone inAntibiotics (Basel, Switzerland) · 2022Article
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTolerance is the ability of bacteria to survive transient exposure to high concentrations of a bactericidal antibiotic without a change in the minimal inhibitory concentration, thereby limiting the efficacy of antimicrobials. The study sought to determine the prevalence of tolerance in a prospective cohort of E. coli bloodstream infection and to explore the association of tolerance with reinfection risk.
methodsTolerance, determined by the Tolerance Disk Test (TDtest), was tested in a prospective cohort of consecutive patient-unique E. coli bloodstream isolates and a collection of strains from patients who had recurrent blood cultures with E. coli (cohorts 1 and 2, respectively). Selected isolates were further analyzed using time-dependent killing and typed using whole-genome sequencing. Covariate data were retrieved from electronic medical records. The association between tolerance and reinfection was assessed by the Cox proportional-hazards regression and a Poisson regression models.
resultsIn cohort 1, 8/94 isolates (8.5%) were tolerant. Using multivariate analysis, it was determined that the risk for reinfection in the patients with tolerant index bacteremia was significantly higher than for patients with a nontolerant strain, hazard ratio, 3.98 (95% confidence interval, 1.32-12.01). The prevalence of tolerance among cohort 2 was higher than in cohort 1, 6/21(28.6%) vs 8/94 (8.5%), respectively (P = .02).
conclusionsTolerant E. coli are frequently encountered among bloodstream isolates and are associated with an increased risk of reinfection. The TDtest appears to be a practicable approach for tolerance detection and could improve future patient management.
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