Heteroresistance

The presence of one or several subpopulations that show antibiotic resistance compared with the majority of the population.

Drug-resistant subpopulations can be enriched during antibiotic exposure and may lead to treatment failure. The resistance phenotype can be unstable and without antibiotic pressure the population reverts to being a minority of the total population. Heteroresistance is challenging to detect and can lead to difficulties in interpretation of susceptibility testing.

Mechanisms and clinical relevance of bacterial heteroresistance (Nature Reviews Microbiology, 2019)

The high prevalence of antibiotic heteroresistance in pathogenic bacteria is mainly caused by gene amplification (Nature Microbiology, 2019)

The highly dynamic nature of bacterial heteroresistance impairs its clinical detection (Communications Biology, 2021)