ArticleNature communications2023
Mixed strain pathogen populations accelerate the evolution of antibiotic resistance in patients.
Article in Nature communications, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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
49 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of Ceftazidime-avibactam in treating Gram-negative infections: a systematic review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Pooled it
- Modeling two-strain competition with reinfection: Mathematical analyses and epidemiological implications.Infectious Disease Modelling · 2026Article
- Predicting resistance evolution to guide antibiotic development.Nature reviews. Microbiology · 2026Review
- Polymorphisms in a bacterial signalling pathway alter evolutionary routes of antibiotic resistance in Escherichia coli.PLoS biology · 2026Article
- Culture-enriched metagenomic sequencing reveals within-patient diversity and transmission of vancomycin-resistantMicrobial genomics · 2026Article
- Antibiotic pressure does not uncover intra-host heterogeneity of Pseudomonas aeruginosa in patients with chronic lung disease.BMC microbiology · 2026Observational
- Phenotypic convergence and collateral susceptibility development in Pseudomonas aeruginosa under antibiotic exposure in ICU patients.npj antimicrobials and resistance · 2026Article
- Culture-enriched metagenomic sequencing reveals within-patient diversity and transmission of vancomycin-resistantmedRxiv : the preprint server for health sciences · 2026Article
- Bacterial co-detection is associated with higher multidrug-resistantJAC-antimicrobial resistance · 2026Article
- Resistance variation and bacterial interactions shape adaptation of a genetically diverse pathogen population to antibiotic therapy.The ISME journal · 2026Article
- Epigenetic regulation and antimicrobial resistance: functional roles of DNA methylation.FEMS microbiology reviews · 2026Review
- Prevalence, Antimicrobial Susceptibility, and Molecular Characteristics of Ceftazidime-Avibactam-ResistantInfection and drug resistance · 2026Article
- Monocellular and Multicellular Parasites Infesting Humans: A Review of Calcium Ion Mechanisms.Biomedicines · 2025Review
- Pharmacodynamic insights to support pneumonia treatment in a patient co-infected with two carbapenem-resistant bacteria.International journal of antimicrobial agents · 2025Article
- Pseudomonas aeruginosa: ecology, evolution, pathogenesis and antimicrobial susceptibility.Nature reviews. Microbiology · 2025Review
- Environment-by-Environment Interactions Differ Across Genetic Backgrounds.Molecular biology and evolution · 2025Article
- Antibiotic Resistance Patterns of Bacteria Involved in Colonization and/or Infection of Patients in Intensive Care Units in Northeastern Romania.Antibiotics (Basel, Switzerland) · 2025Article
- Heterologous expression and optimization of the antimicrobial peptide acidocin 4356 in Komagataella phaffii to target Pseudomonas aeruginosa.Applied microbiology and biotechnology · 2025Article
- Sonochemical synthesis of nanoparticles from bioactive compounds: advances, challenges, and future perspectives.Ultrasonics sonochemistry · 2025Review
- Article
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
Antibiotic resistance poses a global health threat, but the within-host drivers of resistance remain poorly understood. Pathogen populations are often assumed to be clonal within hosts, and resistance is thought to emerge due to selection for de novo variants. Here we show that mixed strain populations are common in the opportunistic pathogen P. aeruginosa. Crucially, resistance evolves rapidly in patients colonized by multiple strains through selection for pre-existing resistant strains. In contrast, resistance evolves sporadically in patients colonized by single strains due to selection for novel resistance mutations. However, strong trade-offs between resistance and growth rate occur in mixed strain populations, suggesting that within-host diversity can also drive the loss of resistance in the absence of antibiotic treatment. In summary, we show that the within-host diversity of pathogen populations plays a key role in shaping the emergence of resistance in response to treatment.
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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.