Antibiotic resistance and persistence—implications for human health and treatment perspectives

Huemer, Markus; Mairpady Shambat, Srikanth; Brugger, Silvio D; Zinkernagel, Annelies S

doi:10.15252/embr.202051034

Cited by 856Bacterial Genetics and BiotechnologyAntimicrobial Resistance in StaphylococcusAntibiotic Resistance in Bacteria

Antibiotic resistance and persistence—implications for human health and treatment perspectives

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Huemer, Markus, Mairpady Shambat, Srikanth, Brugger, Silvio D, Zinkernagel, Annelies S·2020·The EMBO Reports

DOI 10.15252/embr.202051034PMC PMC7726816

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Abstract

Antimicrobial resistance (AMR) and persistence are associated with an elevated risk of treatment failure and relapsing infections. They are thus important drivers of increased morbidity and mortality rates resulting in growing healthcare costs. Antibiotic resistance is readily identifiable with standard microbiological assays, and the threat imposed by antibiotic resistance has been well recognized. Measures aiming to reduce resistance development and spreading of resistant bacteria are being enforced. However, the phenomenon of bacteria surviving antibiotic exposure despite being fully susceptible, so-called antibiotic persistence, is still largely underestimated. In contrast to antibiotic resistance, antibiotic persistence is difficult to measure and therefore often missed, potentially leading to treatment failures. In this review, we focus on bacterial mechanisms allowing evasion of antibiotic killing and discuss their implications on human health. We describe the relationship between antibiotic persistence and bacterial heterogeneity and discuss recent studies that link bacterial persistence and tolerance with the evolution of antibiotic resistance. Finally, we review persister detection methods, novel strategies aiming at eradicating bacterial persisters and the latest advances in the development of new antibiotics.

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Antifungal resistance is linked to specific molecular mechanisms and can be stably inherited by progeny.
“In contrast, resistance is linked to specific molecular mechanisms and can be stably inherited by progeny [15,17–19].”
From Antifungal persistence: Clinical relevance and mechanisms (2025) · cites this paper as [19]
Antifungal persistence is non-heritable, although progeny of persisters may still divide into persistent and non-persistent subpopulations.
“Thirdly, antifungal persistence is non-heritable, although the progeny of persisters may still divide into persistent subpopulations and non-persistent subpopulations.”
From Antifungal persistence: Clinical relevance and mechanisms (2025) · cites this paper as [19]

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Siderophores promote cooperative interspecies and intraspecies cross-protection against antibiotics in vitro
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Antimicrobial Smart Dressings for Combating Antibiotic Resistance in Wound Care
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Recent Advances in Bacterial Persistence Mechanisms
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Citric Acid Confers Broad Antibiotic Tolerance through Alteration of Bacterial Metabolism and Oxidative Stress
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Pharmaceuticals in drinking water sources and tap water in a city in the middle reaches of the Yangtze River: occurrence, spatiotemporal distribution, and risk assessment
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Authors: Huemer, M., Mairpady Shambat, S., Brugger, S. D., & Zinkernagel, A. S.
Affiliations: University of Zurich (CH)
ORCID: Huemer, Markus
Mairpady Shambat, Srikanth
Brugger, Silvio D
Zinkernagel, Annelies S
Venue: The EMBO Reports
Publisher: Springer Science and Business Media LLC
Published: 2020-12-03
Volume: 21
Issue: 12
Pages: e51034-e51034
ISSN: 1469-221X (ISSN-L)
1469-3178
DOI: 10.15252/embr.202051034
PMC: PMC7726816
OpenAlex: W3112882148
Cited by: 850
References: 276
Citations by year: 2026: 155 · 2025: 253 · 2024: 234 · 2023: 129 · 2022: 67 · 2021: 11 · 2020: 1
FWCI: 7.45
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: EMBO Reports (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Zurich Open Repository and Archive (University of Zurich)
Funders: Svenska Sällskapet för Medicinsk Forskning (P17‐0179)
Promedica Stiftung (1449/M)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Bacterial Genetics and Biotechnology
Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
Keywords: antibiotic persistence, antibiotic resistance, bacterial persistence, bacterial heterogeneity, antibiotic tolerance, antibiotic resistance evolution, treatment failure, infection relapse, human health, new antibiotic development
MeSH terms: Anti-Bacterial Agents, Bacteria, Drug Resistance, Microbial, Humans, Drug Resistance, Bacterial

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Antibiotic resistance and persistence—implications for human health and treatment perspectives

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