ArticleJAC-antimicrobial resistance2025
Overview of heteroresistance to multiple antibiotics in clinical
Article in JAC-antimicrobial resistance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 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
5 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
- Droplet microfluidics with image texture quantification for detection of rare antibiotic-resistant subpopulations from bloodstream infections.NPJ digital medicine · 2026Article
- Polymyxin heteroresistance inJournal of medical microbiology · 2026Article
- Phenotypic and genomic characterization of tigecycline heteroresistance in carbapenem-resistantMicrobiology spectrum · 2026Article
- Phage and endolysin-based inhibition ofFrontiers in cellular and infection microbiology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: To assess the prevalence of heteroresistance in 201 clinical isolates of Methods: Isolates were pre-screened for growth of resistant subpopulations at resistant breakpoint concentrations for each isolate/antibiotic combination. Any strain containing colony growth at the resistant breakpoint was selected as a candidate heteroresistant strain, and population analysis profiling (PAP) tested for confirmation of HR phenotype. Dual PAP and time-kill assay were conducted to assess the efficacy of antibiotic combinations in suppressing resistant subpopulations. Results: Ninety-seven percent of isolates were shown to be heteroresistant to at least one antibiotic. Heteroresistance to at least two antibiotics was exhibited by 72.1% of strains. The prevalence of heteroresistance varied across antibiotics, with proportions ranging from 1.5% for imipenem to 85.1% for polymyxin B. The case of Kp486 was heteroresistant to amikacin, ceftazidime/avibactam, tigecycline and polymyxin B. The resistant subpopulations displayed distinct PAP curves and differences in growth and killing kinetics, indicating independent mechanisms for heteroresistance to each of the four antibiotics. Dual PAP experiments showed enhanced killing effects for combinations of antibiotics. In time-kill experiments, pairwise combinations of four drugs achieved a reduction of 3 to 6 logs within 6 h, preventing regrowth of resistant subpopulations. However, combinations with ampicillin did not enhance the activity of tigecycline, polymyxin B or ceftazidime/avibactam. Conclusions: Heteroresistance in clinical
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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.