Multidrug Resistance (MDR) and Collateral Sensitivity in Bacteria, with Special Attention to Genetic and Evolutionary Aspects and to the Perspectives of Antimicrobial Peptides—A Review
Open Access
- 28 June 2020
- Vol. 9 (7), 522
- https://doi.org/10.3390/pathogens9070522
Abstract
Antibiotic poly-resistance (multidrug-, extreme-, and pan-drug resistance) is controlled by adaptive evolution. Darwinian and Lamarckian interpretations of resistance evolution are discussed. Arguments for, and against, pessimistic forecasts on a fatal “post-antibiotic era” are evaluated. In commensal niches, the appearance of a new antibiotic resistance often reduces fitness, but compensatory mutations may counteract this tendency. The appearance of new antibiotic resistance is frequently accompanied by a collateral sensitivity to other resistances. Organisms with an expanding open pan-genome, such as Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae, can withstand an increased number of resistances by exploiting their evolutionary plasticity and disseminating clonally or poly-clonally. Multidrug-resistant pathogen clones can become predominant under antibiotic stress conditions but, under the influence of negative frequency-dependent selection, are prevented from rising to dominance in a population in a commensal niche. Antimicrobial peptides have a great potential to combat multidrug resistance, since antibiotic-resistant bacteria have shown a high frequency of collateral sensitivity to antimicrobial peptides. In addition, the mobility patterns of antibiotic resistance, and antimicrobial peptide resistance, genes are completely different. The integron trade in commensal niches is fortunately limited by the species-specificity of resistance genes. Hence, we theorize that the suggested post-antibiotic era has not yet come, and indeed might never come.Keywords
This publication has 549 references indexed in Scilit:
- Detection of class 1 integron in Acinetobacter baumannii isolates collected from nine hospitals in TurkeyAsian Pacific Journal of Tropical Biomedicine, 2013
- A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiotaFrontiers in Microbiology, 2013
- Bacterial evolution of antibiotic hypersensitivityMolecular Systems Biology, 2013
- The rise of the Enterococcus: beyond vancomycin resistanceNature Reviews Microbiology, 2012
- Evolutionary paths to antibiotic resistance under dynamically sustained drug selectionNature Genetics, 2011
- Genetic Basis for In Vivo Daptomycin Resistance in EnterococciNew England Journal of Medicine, 2011
- Characterisation of a Staphylococcus aureus strain with progressive loss of susceptibility to vancomycin and daptomycin during therapyInternational Journal of Antimicrobial Agents, 2009
- An increasing threat in hospitals: multidrug-resistant Acinetobacter baumanniiNature Reviews Microbiology, 2007
- Tracking the in vivo evolution of multidrug resistance in Staphylococcus aureus by whole-genome sequencingProceedings of the National Academy of Sciences of the United States of America, 2007
- The antibiotic resistome: the nexus of chemical and genetic diversityNature Reviews Microbiology, 2007