Evidence map›Paper›PMID 40565037›Full record

ReviewInternational journal of molecular sciences2025

Metabolic Rewiring of Bacterial Pathogens in Response to Antibiotic Pressure-A Molecular Perspective.

Carlo Acierno, Fannia Barletta, Riccardo Nevola, Luca Rinaldi, Ferdinando Carlo Sasso, Luigi Elio Adinolfi, Alfredo Caturano

Abstract readReview
In one paragraph

Review in International journal of molecular sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed.

  1. Article
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  8. Metabolism-Based Biomarkers for Rapid Phenotypic Antibiotic Susceptibility Testing.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026
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  12. Article
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  17. Review
  18. TheInternational journal of molecular sciences · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Carlo AciernoDepartment of Infectious Diseases, San Carlo Hospital, 85100 Potenza, Italy.ORCID 0000-0002-1239-7012
Fannia BarlettaDepartment of Anesthesiology and Intensive Care, San Carlo Hospital, 85100 Potenza, Italy.
Riccardo NevolaLiver Unit, AORN S. G. Moscati, "A. Landolfi" Hospital, 83029 Solofra, Italy.ORCID 0000-0003-3320-3878
Luca RinaldiDepartment of Medicine and Health Science "Vincenzo Tiberio", Università degli Studi del Molise, 86100 Campobasso, Italy.
Ferdinando Carlo SassoDepartment of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138 Napoli, Italy.ORCID 0000-0002-9142-7848
Luigi Elio AdinolfiDepartment of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138 Napoli, Italy.ORCID 0000-0001-8453-4912
Alfredo CaturanoDepartment of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy.ORCID 0000-0001-7761-7533

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Antibiotic pressure exerts profound effects on bacterial physiology, not limited to classical genetic resistance mechanisms. Increasing evidence highlights the ability of pathogens to undergo metabolic rewiring-an adaptive, reversible reorganization of core metabolic pathways that promotes survival under antimicrobial stress. This review provides a comprehensive analysis of antibiotic-induced metabolic adaptations, encompassing glycolysis, the tricarboxylic acid cycle, fermentation, redox balance, amino acid catabolism, and membrane biosynthesis. We critically examine how diverse antibiotic classes-including β-lactams, aminoglycosides, quinolones, glycopeptides, polymyxins, and antimetabolites-interact with bacterial metabolism to induce tolerance and persistence, often preceding stable resistance mutations. In parallel, we explore the ecological and host-derived signals-such as immunometabolites and quorum sensing-that modulate these metabolic responses. Therapeutically, targeting metabolic pathways offers promising strategies to potentiate antibiotic efficacy, including enzyme inhibition, metabolic adjuvants, and precision-guided therapy based on pathogen metabolic profiling. By framing metabolic plasticity as a dynamic and evolutionarily relevant phenomenon, this review proposes a unifying model linking transient tolerance to stable resistance. Integrating metabolic rewiring into antimicrobial research, clinical diagnostics, and therapeutic design represents a necessary paradigm shift in combating bacterial persistence and resistance.

Indexed as

Anti-Bacterial AgentsBacteriaDrug Resistance, BacterialHumansMetabolic Networks and PathwaysAnti-Bacterial Agentsantibiotic resistanceantibiotic tolerancebacterial persistenceglyoxylate cyclehost–pathogen interactionmembrane adaptationmetabolic adjuvantsmetabolic rewiringquorum sensingredox metabolism

Identifiers

PMID40565037
PMCPMC12193369

What OpenQuestion holds

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Registered trials

None linked

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.