Distinguishing between resistance, tolerance and persistence to antibiotic treatment

Asher Brauner, Ofer Fridman, Orit Gefen, Nathalie Q. Balaban*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1007 Scopus citations

Abstract

Antibiotic tolerance is associated with the failure of antibiotic treatment and the relapse of many bacterial infections. However, unlike resistance, which is commonly measured using the minimum inhibitory concentration (MIC) metric, tolerance is poorly characterized, owing to the lack of a similar quantitative indicator. This may lead to the misclassification of tolerant strains as resistant, or vice versa, and result in ineffective treatments. In this Opinion article, we describe recent studies of tolerance, resistance and persistence, outlining how a clear and distinct definition for each phenotype can be developed from these findings. We propose a framework for classifying the drug response of bacterial strains according to these definitions that is based on the measurement of the MIC together with a recently defined quantitative indicator of tolerance, the minimum duration for killing (MDK). Finally, we discuss genes that are associated with increased tolerance-the 'tolerome'-as targets for treating tolerant bacterial strains.

Original languageEnglish
Pages (from-to)320-330
Number of pages11
JournalNature Reviews Microbiology
Volume14
Issue number5
DOIs
StatePublished - 1 May 2016

Bibliographical note

Publisher Copyright:
© 2016 Macmillan Publishers Limited.

Fingerprint

Dive into the research topics of 'Distinguishing between resistance, tolerance and persistence to antibiotic treatment'. Together they form a unique fingerprint.

Cite this