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dc.contributor.authorWagner, Theresa
dc.contributor.authorHowden, Benjamin P
dc.contributor.authorSundsfjord, Arnfinn
dc.contributor.authorHegstad, Kristin
dc.date.accessioned2023-03-14T12:15:17Z
dc.date.available2023-03-14T12:15:17Z
dc.date.issued2023-01-31
dc.description.abstractAcquisition and expression of antimicrobial resistance (AMR) mechanisms in bacteria are often associated with a fitness cost. Thus, evolutionary adaptation and fitness cost compensation may support the advance of subpopulations with a silent resistance phenotype when the antibiotic selection pressure is absent. However, reports are emerging on the transient nature of silent acquired AMR, describing genetic alterations that can change the expression of these determinants to a clinically relevant level of resistance, and the association with breakthrough infections causing treatment failures. This phenomenon of transiently silent acquired AMR (tsaAMR) is likely to increase, considering the overall expansion of acquired AMR in bacterial pathogens. Moreover, the augmented use of genotypic methods in combination with conventional phenotypic antimicrobial susceptibility testing (AST) will increasingly enable the detection of genotype and phenotype discrepancy. This review defines tsaAMR as acquired antimicrobial resistance genes with a corresponding phenotype within the wild-type distribution or below the clinical breakpoint for susceptibility for which genetic alterations can mediate expression to a clinically relevant level of resistance. References to in vivo resistance development and therapeutic failures caused by selected resistant subpopulations of tsaAMR in Gram-positive and Gram-negative pathogens are given. We also describe the underlying molecular mechanisms, including alterations in the expression, reading frame or copy number of AMR determinants, and discuss the clinical relevance concerning challenges for conventional AST.en_US
dc.identifier.citationWagner T, Howden BP, Sundsfjord A, Hegstad K. Transiently silent acquired antimicrobial resistance: an emerging challenge in susceptibility testing . Journal of Antimicrobial Chemotherapy. 2023en_US
dc.identifier.cristinIDFRIDAID 2124541
dc.identifier.doihttps://doi.org/10.1093/jac/dkad024
dc.identifier.issn0305-7453
dc.identifier.issn1460-2091
dc.identifier.urihttps://hdl.handle.net/10037/28746
dc.language.isoengen_US
dc.publisherOxford University Pressen_US
dc.relation.journalJournal of Antimicrobial Chemotherapy
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0en_US
dc.rightsAttribution-NonCommercial 4.0 International (CC BY-NC 4.0)en_US
dc.titleTransiently silent acquired antimicrobial resistance: an emerging challenge in susceptibility testingen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Med mindre det står noe annet, er denne innførselens lisens beskrevet som Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)