ArticleNature ecology & evolution2022
Within-patient evolution of plasmid-mediated antimicrobial resistance.
Article in Nature ecology & evolution, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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Who cites it
45 citing papers in PubMed, 72 citations in OpenAlex.
- HERA: a web server for host element reference-based aligner.Nucleic acids research · 2026Article
- Modelling the role of the microbiome in antimicrobial resistance across scales.Nature microbiology · 2026Review
- In Silico Genomic Analysis of Antibiotic Resistance Genes Carried by Mobile Genetic Elements inInternational journal of molecular sciences · 2026Article
- Article
- Genome sequencing for prevention of health-care-associated bacterial infections.Nature reviews. Microbiology · 2026Review
- Plasmids promote antimicrobial resistance through insertion sequence-mediated gene inactivation.Nature microbiology · 2026Article
- Evolution and rise of antimicrobial resistance in key public health bacteria within and across the One Health sectors.Future microbiology · 2026Review
- Differential gut transmission of IncP plasmid clades involving hypervirulent Klebsiella pneumoniae reveals plasmid-specific ecological adaptation.Nature communications · 2025Article
- Plasmid streamlining drives the extinction of antibiotic resistance plasmids under selection for horizontal transmission.PLoS biology · 2025Article
- Multi-layered ecological interactions determine growth of clinical antibiotic-resistant strains within human microbiomes.Nature communications · 2025Article
- Tracing the evolutionary dynamics of carbapenem-resistant Escherichia coli in recurrent and multi-site infections.Gut pathogens · 2025Article
- Dissecting pOXA-48 fitness effects in clinical Enterobacterales using plasmid-wide CRISPRi screens.Nature communications · 2025Article
- Genetic determinants of pOXA-48 plasmid maintenance and propagation in Escherichia coli.Nature communications · 2025Article
- The extended mobility of plasmids.Nucleic acids research · 2025Review
- Linear scaling reveals low-dimensional structure in observable microbial dynamics.bioRxiv : the preprint server for biology · 2025Article
- Plasmid conjugation drives within-patient plasmid diversity.Microbial genomics · 2025Article
- The metabolic burden associated with plasmid acquisition: An assessment of the unrecognized benefits to host cells.BioEssays : news and reviews in molecular, cellular and developmental biology · 2025Review
- A plasmid with theMicrobiology (Reading, England) · 2025Article
- Genomic Insights into Bacterial Antimicrobial Resistance Transmission and Mitigation Strategies.Current pharmaceutical biotechnology · 2025Review
- A plasmid-chromosome crosstalk in multidrug resistant enterobacteria.Nature communications · 2024Article
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Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
Abstract
Antimicrobial resistance (AMR) in bacteria is a major threat to public health; one of the key elements in the spread and evolution of AMR in clinical pathogens is the transfer of conjugative plasmids. The drivers of AMR evolution have been studied extensively in vitro but the evolution of plasmid-mediated AMR in vivo remains poorly explored. Here, we tracked the evolution of the clinically relevant plasmid pOXA-48, which confers resistance to the last-resort antibiotics carbapenems, in a large collection of enterobacterial clones isolated from the gut of hospitalized patients. Combining genomic and experimental approaches, we first characterized plasmid diversity and the genotypic and phenotypic effects of multiple plasmid mutations on a common genetic background. Second, using cutting-edge genomic editing in wild-type multidrug-resistant enterobacteria, we dissected three cases of within-patient plasmid-mediated AMR evolution. Our results revealed compensatory evolution of plasmid-associated fitness cost and the evolution of enhanced plasmid-mediated AMR in bacteria evolving in the gut of hospitalized patients. Crucially, we observed that the evolution of pOXA-48-mediated AMR in vivo involves a pivotal trade-off between resistance levels and bacterial fitness. This study highlights the need to develop new evolution-informed approaches to tackle plasmid-mediated AMR dissemination.
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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.