The ecology and evolution of antibiotic-resistant bacteria
Bacteria evolve resistance to antibiotics with near certainty after several years of widespread use. Resistance can evolve via several genetic mechanisms and spread through and between species via gene transfer. Resistance that evolves in agricultural settings can transfer into human populations. Associations among resistance genes, and the process of compensatory evolution, can cause retention of resistance genes, even in the absence of selection favoring resistance. Novel approaches to antimicrobial therapy may provide alternatives to traditional broad-spectrum antibiotics for which resistance is less quick to evolve. To eradicate antibiotic resistance from a hospital setting, researchers need a thorough understanding of the underlying ecology. For example, antibiotic cycling, the hospital equivalent of crop rotation, does not necessarily reduce the environmental heterogeneity at the scale relevant to bacterial clones spreading through the hospital and thus may be ineffective at reducing the frequency of resistant strains in a hospital setting.
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