Resistance Is Mobile: The Accelerating Evolution of Mobile Genetic Elements Encoding Resistance
Author(s): Gunther Jansen, Athena AC
The alarming spread of antibiotic resistance threatens to turn even the most routine treatments of bacterial infection into a Sisyphean task. This is not only a result of proliferation of antibiotic resistant microbes, but also a consequence of horizontal transmission of resistance genes by mobile genetic elements able to transfer resistance genes across bacterial species and environments. Here we discuss two important corollaries of the mobility of drug resistance genes. First, resident commensal microbes in the human gut may act as a reservoir for drug resistance genes which can be horizontally transferred to invading pathogens. Second, mobile genetic elements are under strong selective pressure to acquire drug resistance genes, which facilitates their ability to successfully survive and replicate. These factors lead to the evolution of a more mobile and complex resistome, which in turn increases the incidence of difficult-to-treat infectious diseases. We therefore urge that mobility of resident resistance genes be considered in empirical studies, theoretical models of the spread of resistance, and therapeutic decision making.