Antibiotic resistance research calls for tests that reflect bacteria's changing environments

The World Health Organization has identified antimicrobial resistance, including antibiotic resistance, as a major global health concern. Traditional understanding of antibiotic resistance, based on laboratory tests, classifies bacteria as either susceptible or resistant to specific antibiotics. However, researchers argue that this understanding may need to be revised in light of new findings.

A group of researchers from DTU National Food Institute and the University of Copenhagen have published an opinion piece in Trends in Microbiology, suggesting that antibiotic resistance should be viewed as a dynamic trait that changes depending on the bacterial environment. Factors such as temperature, oxygen levels, pH, patient's fever, and whether the bacteria are in the gut or bloodstream can all impact whether a bacterium with a resistance gene actually behaves in a resistant manner.

Current standard laboratory tests do not account for these biological conditions, potentially leading to misinterpretations of a bacterium's resistance status. The researchers argue that resistance genes alone do not determine resistance; rather, it is the combination of genes and the specific conditions under which the bacteria exist.

This paradigm shift in understanding antibiotic resistance opens up possibilities for more targeted treatment strategies and improved monitoring of resistance in humans, animals, and the environment. To implement these changes, researchers suggest collecting extensive new data on resistance across various biological conditions and leveraging computational models and artificial intelligence to better understand gene-environment interactions.