ArticleNature communications2024
Three concurrent mechanisms generate gene copy number variation and transient antibiotic heteroresistance.
Article in Nature communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global trends and research profile of antibiotic heteroresistance: a bibliometric and visual analysis.Frontiers in microbiology · 2026Pooled it
- Transcriptional regulation drives heteroresistance inmSystems · 2026Article
- Heterogeneity in the response to the metabolic environment drives fosfomycin heteroresistance.Nature communications · 2026Article
- Bacterial heteroresistance mechanisms, dynamics, and emerging diagnostic approaches.Bioscience reports · 2026Review
- Gain and loss of plasmid-borne antibiotic resistance genes are associated with chromosomal resistance presence in Enterobacteriaceae.mSystems · 2026Article
- Resistance potentiators: Evolutionary catalysts of antibiotic resistance.PLoS biology · 2026Article
- Antibiotic resistance in E.coli isolated from mint in local markets in Hebron, Palestine.BMC microbiology · 2026Article
- Droplet microfluidics with image texture quantification for detection of rare antibiotic-resistant subpopulations from bloodstream infections.NPJ digital medicine · 2026Article
- Heteroresistance to amikacin inMicrobiology spectrum · 2026Article
- Genome-wide characteristics, antibiotic resistance, and pathogenicity analysis of Streptococcus parasuis strains isolated from diseased pigs.BMC microbiology · 2026Article
- The dynamic distribution of genetic tandem amplifications in a heteroresistant Escherichia coli population revealed by ultra-deep long read sequencing.Nature communications · 2026Article
- Genotype-Phenotype Links Between Aminoglycoside-Modifying Enzymes and Aminoglycoside MICs in Aminoglycoside-ResistantMicroorganisms · 2026Article
- Article
- Heterogeneous multicopy of blaNature communications · 2026Article
- Antechokinetics, the kinetics of antimicrobial resistance molecules.Frontiers in pharmacology · 2026Review
- Cooperative antibiotic resistance in bacteria: beyond biofilms.Frontiers in microbiology · 2026Review
- Cell-to-Cell and Patient-to-Patient Variability in Antimicrobial Resistance.Microorganisms · 2025Review
- Nitrogen-fixing microbes gain genes in diverse types of living environments.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Improving time-to-result: head-to-head comparison of three rapid AST systems for Gram-negative bacteremia, including the newly developed VITEK REVEAL.Journal of clinical microbiology · 2025Article
- Effectiveness of CRISPR-Cas in sensitizing bacterial populations with plasmid-encoded antimicrobial resistance.Genetics · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Heteroresistance is a medically relevant phenotype where small antibiotic-resistant subpopulations coexist within predominantly susceptible bacterial populations. Heteroresistance reduces treatment efficacy across diverse bacterial species and antibiotic classes, yet its genetic and physiological mechanisms remain poorly understood. Here, we investigated a multi-resistant Klebsiella pneumoniae isolate and identified three primary drivers of gene dosage-dependent heteroresistance for several antibiotic classes: tandem amplification, increased plasmid copy number, and transposition of resistance genes onto cryptic plasmids. All three mechanisms imposed fitness costs and were genetically unstable, leading to fast reversion to susceptibility in the absence of antibiotics. We used a mouse gut colonization model to show that heteroresistance due to elevated resistance-gene dosage can result in antibiotic treatment failures. Importantly, we observed that the three mechanisms are prevalent among Escherichia coli bloodstream isolates. Our findings underscore the necessity for treatment strategies that address the complex interplay between plasmids, resistance cassettes, and transposons in bacterial populations.
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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.