296716

Heteroresistance: A Gray Side of Antimicrobial Susceptibility Testing

Article

Last updated: 03 Jan 2025

Subjects

-

Tags

Section E: Microbiology & Immunology

Abstract

Antibiotic resistance is a universal warning to human health; by 2050, it is expected that the mortality rate due to antimicrobial resistance (AMR) will exceed 10 Million. Heteroresistance (HR) is a phenomenon in which subpopulations of cells exhibit lower levels of antibiotic susceptibility compared to the main population. There are no standard methods to detect HR leading to inappropriate use of this expression. HR has been distinguished since 1947 and reported in Gram-negative and Gram-positive bacteria. Recently, HR is so prevalent in various bacterial species against the plethora of antibiotic classes. HR which has an unstable phenotypic character, having different mechanisms with non-standard methods to be determined, prevents recognition of the degree to which this phenomenon is precarious and its consequences. In 2009, World Health Organization (WHO) has defined antibiotic resistance (AbR) as a critical public health threat causing death rates more than that caused by cancer and such serious diseases. Consequently, understanding the novel and often under-recognized mechanisms of resistance that represent barriers to antibiotic efficacy is vital so as to combat resistance with new therapeutic approaches. Eventually, a fundamental issue is whether we can predict why some resistant clones have the ability to survive despite the perishing of the main population. In this review, we will assess the available literature on bacterial HR suggesting recommendations for the definition and determination criteria for antibiotic HR to help assess the treatment failure caused by heteroresistant bacteria.

DOI

10.21608/aprh.2023.193384.1212

Keywords

Heteroresistant cells, Phenotype, genotype, Population Analysis Profile, Treatment Failure

Authors

First Name

Alaa

Last Name

Al-Shebiny

MiddleName

-

Affiliation

Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University, Ain-Helwan, Cairo, Egypt

Email

alaa.gamal@pharm.helwan.edu.eg

City

-

Orcid

-

First Name

Riham

Last Name

Shawky

MiddleName

-

Affiliation

Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University, Ain-Helwan, Cairo, Egypt

Email

dr.rihamshawky@pharm.helwan.edu.eg

City

-

Orcid

-

First Name

Mohamed

Last Name

Emara

MiddleName

-

Affiliation

Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University, Ain-Helwan, Cairo, Egypt

Email

mohamed_emara@pharm.helwan.edu.eg

City

Cairo

Orcid

0000-0001-7708-9435

Volume

7

Article Issue

2

Related Issue

41025

Issue Date

2023-04-01

Receive Date

2023-02-12

Publish Date

2023-04-01

Page Start

101

Page End

110

Print ISSN

2357-0547

Online ISSN

2357-0539

Link

https://aprh.journals.ekb.eg/article_296716.html

Detail API

https://aprh.journals.ekb.eg/service?article_code=296716

Order

3

Type

Review Article

Type Code

358

Publication Type

Journal

Publication Title

Journal of Advanced Pharmacy Research

Publication Link

https://aprh.journals.ekb.eg/

MainTitle

Heteroresistance: A Gray Side of Antimicrobial Susceptibility Testing

Details

Type

Article

Created At

23 Dec 2024