Persistent Bacterial Infections, Antibiotic Treatment Failure, and Microbial Adaptive Evolution

Abstract

Antibiotic resistance is expected by the WHO to be the biggest threat to human health before 2050. In this overview, we argue that this prediction may in fact be too optimistic because it is often overlooked that many bacterial infections frequently ‘go under the radar’ because they are difficult to diagnose and characterize. Due to our lifestyle, persistent infections caused by opportunistic bacteria—well-known or emerging—show increasing success of infecting patients with reduced defense capacity, and often antibiotics fail to be sufficiently effective, even if the bacteria are susceptible, leaving small bacterial populations unaffected by treatment in the patient. The mechanisms behind infection persistence are multiple, and therefore very difficult to diagnose in the laboratory and to treat. In contrast to antibiotic resistance associated with acute infections caused by traditional bacterial pathogens, genetic markers associated with many persistent infections are imprecise and mostly without diagnostic value. In the absence of effective eradication strategies, there is a significant risk that persistent infections may eventually become highly resistant to antibiotic treatment due to the accumulation of genomic mutations, which will transform colonization into persistence.

SERS nanowire chip and machine learning enabled instant identification and classification of clinically relevant wild-type and antibiotic resistant bacteria at species and strain level

“…Post-optimisation, we acquired SERS spectra of individual bacteria solution using Ag coated Si NWSERS chips and created a database of vibrational energy levels incorporating molecular fingerprint information. The SERS spectra were collected from 12 groups of disease-causing microbes: Mycobacterium tuberculosis H37Ra (ATCC 25177), Mycobacterium smegmatis MC 2 155 (ATCC 700084), Escherichia coli K12 (ATCC 700926), Klebsiella pneumoniae 33495 (ATCC 33495), Enterobacter cloacae 10005 (ATCC 13047), Pseudomonas aeruginosa Migula (ATCC 27853), Staphylococcus aureus 7447 (ATCC 6538P), Paenibacillus borealis SB1 (MTCC 8085), Bacillus clausii 1779 (MTCC 11713), Bacillus subtilis 3610 (MTCC 121), Xanthobacter autotrophicus 10809 (MTCC 132), and Pseudomonas citronellolis 50332 (MTCC 1191). The bacterial sample preparation details are provided in the supplementary section 6.…”

“…In recent years, the massive increase of infections caused by microorganisms has sought immediate attention from the public health care sector. 1,2 Microorganisms can cause severe infections and cause significant morbidity and motality. 2 According to WHO, more than 1.2 million people died from severe bacterial infections in the respiratory, gastrointestinal, and central nervous systems.…”

“…1,2 Microorganisms can cause severe infections and cause significant morbidity and motality. 2 According to WHO, more than 1.2 million people died from severe bacterial infections in the respiratory, gastrointestinal, and central nervous systems. 3 A healthy individual can acquire pathogens either from other humans, the environment (contaminated food, water, and air) or pets, farm animals (zoonotic transmission).…”

Microfluidic Chip for Detection of Drug Resistance at the Single-cell Level

“…Antibiotic resistant bacteria have also been detected in the residential environment. A discovery and developmental pipeline of new antibiotics is needed to combat bacterial antibiotic resistance [ 2 , 3 , 4 ]. Antimicrobial suscept ibility testing (AST) is essential to identify the proper antibiotic for a given bacterial infection.…”

Whole-Genome Sequencing and Drug-Susceptibility Analysis of Serial Mycobacterium abscessus Isolates from Thai Patients

“…These two forms of infection differ in their implications for patient management and control. In cases of persistent infection there is a need to adjust the treatment regimen, whereas in reinfection cases there is a need to control the source of infection [ 5 ]. When treatment of M. abscessus appears to have failed, it is important for epidemiological and patient-management strategies to be able to distinguish between RI and PI.…”