TY - JOUR
T1 - Distinguishing between resistance, tolerance and persistence to antibiotic treatment
AU - Brauner, Asher
AU - Fridman, Ofer
AU - Gefen, Orit
AU - Balaban, Nathalie Q.
N1 - Publisher Copyright:
© 2016 Macmillan Publishers Limited.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84964318468&partnerID=8YFLogxK
U2 - 10.1038/nrmicro.2016.34
DO - 10.1038/nrmicro.2016.34
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C2 - 27080241
AN - SCOPUS:84964318468
SN - 1740-1526
VL - 14
SP - 320
EP - 330
JO - Nature Reviews Microbiology
JF - Nature Reviews Microbiology
IS - 5
ER -