San Millan, Alvaro. Evolution of Plasmid-Mediated Antibiotic Resistance in the Clinical Context
Trends Microbiol. 2018 Dec; 26(12): 978-985.
Antibiotic-resistant infections are an urgent problem in clinical settings because they sharply increase mortality risk in critically ill patients. The horizontal spread of antibiotic resistance genes among bacteria is mainly driven by extra-chromosomal DNA elements known as plasmids. Bacterial plasmids disseminate resistance genes among the most worrisome clinical pathogens. Crucially, some of the associations between resistance plasmids and bacterial clones become especially successful, creating 'superbugs' that spread uncontrollably in hospitals. However, we are still a long way from understanding the molecular and evolutionary mechanisms that determine the success of these associations in the clinical context. In this new paper, Alvaro explores some of the key factors involved in the evolution of plasmid-mediated antibiotic resistance.