Heterogeneous subpopulations in Escherichia coli strains acquire adaptive resistance to imipenem treatment through rapid transcriptional regulation

IntroductionHeteroresistance is a well-known phenomenon contributing to treatment failure in bacterial infections. Previous research has traditionally linked it to genetic mechanisms, emphasizing fixed subpopulations with specific resistance mutations. Recent studies appreciated that bacterial subpo...

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Main Authors: YunTao Luo, Rong Xu, Bo Yuan, WeiHua Yang, YunHeng Zhou, Yuan Tian, QingZhong Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2025.1563316/full
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author YunTao Luo
Rong Xu
Bo Yuan
WeiHua Yang
YunHeng Zhou
Yuan Tian
QingZhong Wang
author_facet YunTao Luo
Rong Xu
Bo Yuan
WeiHua Yang
YunHeng Zhou
Yuan Tian
QingZhong Wang
author_sort YunTao Luo
collection DOAJ
description IntroductionHeteroresistance is a well-known phenomenon contributing to treatment failure in bacterial infections. Previous research has traditionally linked it to genetic mechanisms, emphasizing fixed subpopulations with specific resistance mutations. Recent studies appreciated that bacterial subpopulations may not be fixed and independent, but rather dynamically changing. Heteroresistance mechanisms are likely more intricate than mere genetic predisposition alone.MethodsOur study investigated the role of non-genetically encoded mechanisms in early stages of occurrence and development of heteroresistance through transcriptome analysis and molecular biology experiments.ResultsWe identified a clinical Escherichia coli strain that, despite no prior antibiotic treatment, still exhibited imipenem heteroresistance. We found that these heteroresistance populations can rapidly acquire adaptive capability for imipenem-resistance through an active and dynamic gene regulatory process. At their highly resistant stage, the transcriptome is primarily characterized by enhanced expression of related genes in exopolysaccharide and peptidoglycan biosynthesis (wcaE, wcaF, mrcB, murA, etc), leading to critical alterations in bacterial intracellular and intercellular structure, including maintaining the integrity of the outer cell membrane and the promotion of biofilm formation. Conversely, in antibiotics-free conditions, these highly imipenem-resistant subpopulations can revert to an imipenem-sensitive state, accompanied by reversed gene expression. Additionally, we discovered that extremely low-level antibiotic exposure can regenerate heteroresistance populations, accompanied by similar pattern of gene expression.DiscussionOverall, our study revealed non-genetic mechanisms that enable bacterial strains to acquire adaptive imipenem-resistance rapidly. Moreover, preventing hospital-acquired infections should focus not only on eliminating residual bacteria but also on removing residual antibiotics in clinical settings.
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spelling doaj-art-567fa0b5cd6e4d2ab9f1daa2f74d946f2025-08-20T03:21:47ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-05-011510.3389/fcimb.2025.15633161563316Heterogeneous subpopulations in Escherichia coli strains acquire adaptive resistance to imipenem treatment through rapid transcriptional regulationYunTao Luo0Rong Xu1Bo Yuan2WeiHua Yang3YunHeng Zhou4Yuan Tian5QingZhong Wang6Clinical Microbiology Laboratory, Shanghai Center for Clinical Laboratory, Shanghai, ChinaClinical Microbiology Laboratory, Shanghai Center for Clinical Laboratory, Shanghai, ChinaOutpatient Department of Clinical Laboratory, Shanghai Tenth People’s Hospital, Shanghai, ChinaDepartment of Clinical Laboratory, Zhabei Central Hospital of Jing’an District, Shanghai, ChinaDepartment of Clinical Laboratory, Zhabei Central Hospital of Jing’an District, Shanghai, ChinaShanghai Institute of Immunity and Infection, Chinese Academy of Sciences, Shanghai, ChinaClinical Microbiology Laboratory, Shanghai Center for Clinical Laboratory, Shanghai, ChinaIntroductionHeteroresistance is a well-known phenomenon contributing to treatment failure in bacterial infections. Previous research has traditionally linked it to genetic mechanisms, emphasizing fixed subpopulations with specific resistance mutations. Recent studies appreciated that bacterial subpopulations may not be fixed and independent, but rather dynamically changing. Heteroresistance mechanisms are likely more intricate than mere genetic predisposition alone.MethodsOur study investigated the role of non-genetically encoded mechanisms in early stages of occurrence and development of heteroresistance through transcriptome analysis and molecular biology experiments.ResultsWe identified a clinical Escherichia coli strain that, despite no prior antibiotic treatment, still exhibited imipenem heteroresistance. We found that these heteroresistance populations can rapidly acquire adaptive capability for imipenem-resistance through an active and dynamic gene regulatory process. At their highly resistant stage, the transcriptome is primarily characterized by enhanced expression of related genes in exopolysaccharide and peptidoglycan biosynthesis (wcaE, wcaF, mrcB, murA, etc), leading to critical alterations in bacterial intracellular and intercellular structure, including maintaining the integrity of the outer cell membrane and the promotion of biofilm formation. Conversely, in antibiotics-free conditions, these highly imipenem-resistant subpopulations can revert to an imipenem-sensitive state, accompanied by reversed gene expression. Additionally, we discovered that extremely low-level antibiotic exposure can regenerate heteroresistance populations, accompanied by similar pattern of gene expression.DiscussionOverall, our study revealed non-genetic mechanisms that enable bacterial strains to acquire adaptive imipenem-resistance rapidly. Moreover, preventing hospital-acquired infections should focus not only on eliminating residual bacteria but also on removing residual antibiotics in clinical settings.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1563316/fullheteroresistancetranscriptional regulationEscherichia colinon-genetic mechanismfitness cost
spellingShingle YunTao Luo
Rong Xu
Bo Yuan
WeiHua Yang
YunHeng Zhou
Yuan Tian
QingZhong Wang
Heterogeneous subpopulations in Escherichia coli strains acquire adaptive resistance to imipenem treatment through rapid transcriptional regulation
Frontiers in Cellular and Infection Microbiology
heteroresistance
transcriptional regulation
Escherichia coli
non-genetic mechanism
fitness cost
title Heterogeneous subpopulations in Escherichia coli strains acquire adaptive resistance to imipenem treatment through rapid transcriptional regulation
title_full Heterogeneous subpopulations in Escherichia coli strains acquire adaptive resistance to imipenem treatment through rapid transcriptional regulation
title_fullStr Heterogeneous subpopulations in Escherichia coli strains acquire adaptive resistance to imipenem treatment through rapid transcriptional regulation
title_full_unstemmed Heterogeneous subpopulations in Escherichia coli strains acquire adaptive resistance to imipenem treatment through rapid transcriptional regulation
title_short Heterogeneous subpopulations in Escherichia coli strains acquire adaptive resistance to imipenem treatment through rapid transcriptional regulation
title_sort heterogeneous subpopulations in escherichia coli strains acquire adaptive resistance to imipenem treatment through rapid transcriptional regulation
topic heteroresistance
transcriptional regulation
Escherichia coli
non-genetic mechanism
fitness cost
url https://www.frontiersin.org/articles/10.3389/fcimb.2025.1563316/full
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