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Antibiotic resistance

Plasmid evolution in the clinic

Nature Ecology & Evolution volume 6, pages 1806–1807 (2022)Cite this article

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Plasmids are well known for transferring antibiotic resistance genes between bacteria. A study in the clinic shows that evolutionary dynamics within the gut microbiomes of hospitalized patients lead to rapid adaptive changes, balancing the level of resistance that plasmids provide against the fitness costs that they impose on bacteria.

This study is part of a large European project called R-GNOSIS that sampled gut enterobacteria from more than 9,000 patients during hospital stays over a 2-year period. A previous study showed that conjugative plasmids carrying resistance genes against last-line antibiotic treatments were being transferred between bacterial lineages in the gut microbiomes of the hospitalized patients11. As such, plasmid HGT drives the rapid emergence and spread of resistance to the antibiotic carbapenem within some patients. DelaFuente et al. focused on around 200 of these bacterial isolates, each carrying a variant of the carbapenem resistance plasmid pOXA-48. To test for differences in the fitness costs associated with carrying these plasmid variants, they first transferred each plasmid into a ‘common garden’ using Escherichia coli as host. Fitness costs varied among the plasmid variants and, crucially, increased with the level of carbapenem resistance that the plasmid provided. By contrast, variation in plasmid fitness cost could not be explained by variation in other plasmid traits, such as conjugation rate or the number of plasmid copies per cell. Costlier plasmids therefore provided higher levels of antibiotic resistance.

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Fig. 1: A trade-off governs plasmid evolution in the clinic.

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  1. Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

    Rosanna C. T. Wright & Michael A. Brockhurst

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  1. Rosanna C. T. Wright
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  2. Michael A. Brockhurst
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Correspondence to Michael A. Brockhurst.

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Wright, R.C.T., Brockhurst, M.A. Plasmid evolution in the clinic. Nat Ecol Evol 6, 1806–1807 (2022). https://doi.org/10.1038/s41559-022-01907-8

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