Evolution of Bacterial Tolerance Under Antibiotic Treatment and Its Implications on the Development of Resistance

Recent laboratory evolution studies have shown that upon repetitive antibiotic treatments, bacterial populations will adapt and eventually became tolerant and resistant to the drug. Drug tolerance rapidly evolves upon frequent, intermittent antibiotic treatments, and such emerging drug tolerance seems to be specific to the treatment conditions, complicating clinical practice. Moreover, it has been shown that tolerance often promotes the development of resistance, which further reinforces the need of clinical diagnostics for antibiotic tolerance to reduce the occurrence of acquired resistance. Here, we discuss the laboratory evolution studies that were performed to track the development of tolerance in bacterial populations, and highlight the urgency of developing a comprehensive knowledge base of various tolerance phenotypes and their detection in clinics. Finally, we propose future directions for basic research in this growing field.

Automated summary

Recent laboratory evolution studies have demonstrated that bacterial populations will adapt and become tolerant and resistant upon repetitive antibiotic treatments. The development of tolerance often promotes the emergence of resistance, highlighting the importance of clinical diagnostics for antibiotic tolerance to reduce acquired resistance. Future directions for basic research in this field include tracking the development of tolerance in bacterial populations and developing a comprehensive knowledge base of various tolerance phenotypes for detection in clinics.