Emergence and spread of antibiotic resistance: setting a parameter space

Abstract

The emergence and spread of antibiotic resistance among human pathogens is a relevant problem for human health and one of the few evolution processes amenable to experimental studies. In the present review, we discuss some basic aspects of antibiotic resistance, including mechanisms of resistance, origin of resistance genes, and bottlenecks that modulate the acquisition and spread of antibiotic resistance among human pathogens. In addition, we analyse several parameters that modulate the evolution landscape of antibiotic resistance. Learning why some resistance mechanisms emerge but do not evolve after a first burst, whereas others can spread over the entire world very rapidly, mimicking a chain reaction, is important for predicting the evolution, and relevance for human health, of a given mechanism of resistance. Because of this, we propose that the emergence and spread of antibiotic resistance can only be understood in a multi-parameter space. Measuring the effect on antibiotic resistance of parameters such as contact rates, transfer rates, integration rates, replication rates, diversification rates, and selection rates, for different genes and organisms, growing under different conditions in distinct ecosystems, will allow for a better prediction of antibiotic resistance and possibilities of focused interventions.

Key words::

• Antibiotic resistance
• evolution
• horizontal gene transfer
• resistome

Acknowledgements

This work is honoring Prof. Otto Cars, a man of unshakeable honesty, and a leader in science and in service to society. Work in the laboratory of J.L.M. is supported by grants BIO2011-25255 from the Spanish Ministry of Economy and Competitivity, S2010/BMD2414 (PROMPT) from CAM, Spanish Network for Research on Infectious Diseases (REIPI RD12/0015) from the Instituto de Salud Carlos III, and HEALTH-F3-2011-282004 (EVOTAR). Work in the laboratory of F.B. is funded by research grants from the European Commission (EvoTAR-FP-HEALTH-F3-2011-282004), the CIBERESP Research Network in Epidemiology and Public Health (CB06/02/0053), and the Regional Government of Madrid (PROMPT-CM-CM S2010/BMD-2414).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.