Bacterial L-forms: Key Mechanisms of Drug Resistance, Disease Recurrence, and Immune Evasion.

Songling Lei, Dan Chen, Junliang Wu, Kewang Hu, Mingli Zhu

Abstract readReview

In one paragraph

Review in Indian journal of microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it

0cells of the map it votes in

1citing 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

1 citing paper in PubMed.

Heteroresistance inFrontiers in cellular and infection microbiology · 2026
Review

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

5 authors.

Songling LeiHangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.

Dan ChenHangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.

Junliang WuHangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.

Kewang HuHangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.

Mingli ZhuHangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.ORCID 0000-0002-6758-2274

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Abstract: Bacteria enter the L-form state after shedding their cell walls in response to adverse conditions for survival; these bacteria can revert to their walled morphology after the unfavorable factors are removed. Bacterial L-forms can be either unstable (typically observed in clinically isolated and induced L-forms) or stable (associated with two specific mutation types). In recent years, bacterial L-forms have been implicated in antibiotic resistance, disease recurrence, and origin of life. However, because identifying bacterial L-forms is difficult, they are often overlooked in clinical settings. In this review, we elucidate the relationships of bacterial L-forms with their cell walls, mutation, proliferation, antibiotic resistance, and disease recurrence, as well as with the host immune system. We also highlight the challenges and future prospects for bacterial L-form research. Graphical Abstract:

Indexed as

Bacterial L-formBacterial resistanceCell wallCell wall–deficient bacteriaImmune systemInfectious disease

Identifiers

PMID42325468

DOI10.1007/s12088-025-01522-8

PMCPMC13280103

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Registered trials

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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.