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BMC Medicine
Published in: BMC Medicine 1/2012

Open Access 01-12-2012 | Research article

Implications of stress-induced genetic variation for minimizing multidrug resistance in bacteria

Authors: Uri Obolski, Lilach Hadany

Published in: BMC Medicine | Issue 1/2012

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Abstract

Background

Antibiotic resistance in bacterial infections is a growing threat to public health. Recent evidence shows that when exposed to stressful conditions, some bacteria perform higher rates of horizontal gene transfer and mutation, and thus acquire antibiotic resistance more rapidly.

Methods

We incorporate this new notion into a mathematical model for the emergence of antibiotic multi-resistance in a hospital setting.

Results

We show that when stress has a considerable effect on genetic variation, the emergence of antibiotic resistance is dramatically affected. A strategy in which patients receive a combination of antibiotics (combining) is expected to facilitate the emergence of multi-resistant bacteria when genetic variation is stress-induced. The preference between a strategy in which one of two effective drugs is assigned randomly to each patient (mixing), and a strategy where only one drug is administered for a specific period of time (cycling) is determined by the resistance acquisition mechanisms. We discuss several features of the mechanisms by which stress affects variation and predict the conditions for success of different antibiotic treatment strategies.

Conclusions

These findings should encourage research on the mechanisms of stress-induced genetic variation and establish the importance of incorporating data about these mechanisms when considering antibiotic treatment strategies.
Appendix
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Metadata
Title
Implications of stress-induced genetic variation for minimizing multidrug resistance in bacteria
Authors
Uri Obolski
Lilach Hadany
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2012
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-10-89

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