Drug-resistant bacteria are emerging worldwide, despite frequently being less fit than drug-susceptible strains1. Data from model systems suggest the fitness cost of antimicrobial resistance can be mitigated by compensatory mutations2. However, current evidence that compensatory evolution plays any significant role in the success of drug-resistant bacteria in human populations is weak3–6. Here we describe a set of novel compensatory mutations in the RNA polymerase of rifampicin-resistant Mycobacterium tuberculosis, the etiologic agent of human tuberculosis (TB). M. tuberculosis strains harbouring these compensatory mutations exhibited a high competitive fitness in vitro. Moreover, these mutations were associated with high in vivo fitness as determined by their relative clinical frequency across patient populations. Importantly, in countries with the world’s highest incidence of multidrug-resistant (MDR) TB7, more than 30% of MDR clinical isolates had such a mutation. Our findings support a role for compensatory evolution in the global epidemics of MDR-TB8.

In an outbreak investigation of Mycobacterium tuberculosis comparing whole genome sequencing (WGS) with traditional genotyping, Stefan Niemann and colleagues found that classical genotyping falsely clustered some strains, and WGS better reflected contact tracing.

The opportunistic human fungal pathogen Candida glabrata is closely related to Saccharomyces cerevisiae, yet it has evolved to survive within mammalian hosts. Which traits help C. glabrata to adapt to this different environment? Which specific responses are crucial for its survival in the host? The main differences seem to include an extended repertoire of adhesin genes, high drug resistance, an enhanced ability to sustain prolonged starvation and adaptations of the transcriptional wiring of key stress response genes. Here, we discuss the properties of C. glabrata with a focus on the differences to related fungi.

The opportunistic human fungal pathogen Candida glabrata is confronted with phagocytic cells of the host defence system. Survival of internalized cells is thought to contribute to successful dissemination. We investigated the reaction of engulfed C. glabrata cells using fluorescent protein fusions of the transcription factors CgYap1 and CgMig1 and catalase CgCta1. The expression level and peroxisomal localization of catalase was used to monitor the metabolic and stress status of internalized C. glabrata cells. These reporters revealed that the phagocytosed C. glabrata cells were exposed to transient oxidative stress and starved for carbon source. Cells trapped within macrophages increased their peroxisome numbers indicating a metabolic switch. Prolonged phagocytosis caused a pexophagy-mediated decline in peroxisome numbers. Autophagy, and in particular pexophagy, contributed to survival of C. glabrata during engulfment. Mutants lacking CgATG11 or CgATG17, genes required for pexophagy and non-selective autophagy, respectively, displayed reduced survival rates. Furthermore, both CgAtg11 and CgAtg17 contribute to survival, since the double mutant was highly sensitive to engulfment. Inhibition of peroxisome formation by deletion of CgPEX3 partially restored viability of CgATG11 deletion mutants during engulfment. This suggests that peroxisome formation and maintenance might sequester resources required for optimal survival. Mobilization of intracellular resources via autophagy is an important virulence factor that supports the viability of C. glabrata in the phagosomal compartment of infected innate immune cells.