Antibiotics exert selective pressures
on clinically relevant antibiotic
resistance. It is critical to understand how antibiotic resistance
evolves in environmental microbes exposed to subinhibitory concentrations
of antibiotics and whether evolutionary dynamics and emergence of
resistance are predictable. In this study, Comamonas testosteroni isolated from wastewater activated sludge were subcultured in a
medium containing 10 ng/mL cefepime for 40 days (∼300 generations).
Stepwise mutations were accumulated, leading to an ultimate 200-fold
increase in the minimum inhibitory concentration (MIC) of cefepime.
Early stage mutation in DNA polymerase-encoding gene dnaE2 played an important role in antibiotic resistance evolution. Diverse
resistance mechanisms were employed and validated experimentally,
including increased efflux, biofilm formation, reduced antibiotic
uptake, and drug inactivation. The cefepime minimal selective concentrations
(MSCs) and relative fitness of susceptible, intermediate, and resistant
mutants were determined. Agent-based modeling of the modified Moran
process enabled simulations of resistance evolution and predictions
of the emergence time and frequency of resistant mutants. The unraveled
cefepime resistance mechanisms could be employed by broader bacteria,
and the newly developed model is applicable to the predictions of
general resistance evolution. The improved knowledge facilitates the
assessment, prediction, and mitigation of antibiotic resistance progression
in antibiotic-polluted environments.