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Antibiotic resistance and persistence—Implications for human health and treatment perspectives
Open accessAbstract
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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“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]
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“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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Metadata
- Authors
- Huemer, M., Mairpady Shambat, S., Brugger, S. D., & Zinkernagel, A. S.
- Affiliations
- University of Zurich (CH)
- Venue
- The EMBO Reports
- Published
- 2020-12-03
- Volume
- 21
- Issue
- 12
- Pages
- e51034-e51034
- ISSN
- 1469-221X (ISSN-L)
- 1469-3178
- 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
- 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
- Health Sciences › Medicine › Microbiology (medical) › 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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