Ecological and Evolutionary Drivers of Antibiotic Resistance in Patients

Lead Research Organisation: University of Oxford
Department Name: Biology

Abstract

Antibiotic resistance in pathogenic bacteria poses a fundamental threat to human health. The overarching aim of this project is to
determine the ecological and evolutionary processes that drive the emergence and loss of antibiotic resistance in hospitalized
patients. The first objective of this project is to uncover drivers of resistant infections. Specifically, we will determine the relative
contribution of (i) de novo variation, (ii) pre-existing variation and (iii) superinfection to the emergence of resistance as a function ofantibiotic treatment. The second objective of the project is to determine key factors that shape the stability of resistance in patients.Specifically, we will (i) measure the cost of resistance, (ii) test for compensatory evolution in resistant populations and (iii) test the hypothesis that high fitness costs accelerate the loss of antibiotic resistance in the absence of antibiotic treatment. The third objective of this project is to determine the impact of antibiotic treatment on genome evolution. Specifically, we will (i) measure the impact of antibiotic treatment on the rate of molecular evolution and (ii) systematically identify genetic drivers of resistance. To achieve these objectives we will use samples and data collected during ASPIRE-ICU, a large scale clinical trial of infections caused by the opportunistic pathogen P.aeruginosa. Characterization of isolates from large numbers of longitudinally sampled patients with varying antibiotic treatment regimes will allow us to study the phenotypic and genomic responses to antibiotic treatment. Experimental evolution with clinical isolates will let us directly test the role of key variables that are predicted to shape antibiotic resistance. The novel combination of clinical sampling, experimental evolution and genomic analyses will allow us to generate unprecedented insights intIn this project we will investigate the ecological and evolutionary drivers of antibiotic resistant infection.

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