Phenotypic and genomic characterization of tigecycline heteroresistance in carbapenem-resistant <i>Klebsiella pneumoniae</i>

This study provides crucial insights into the phenomenon of tigecycline heteroresistance (Tgc-HR) in carbapenem-resistant <i>Klebsiella pneumoniae</i>. It highlights the stability of heteroresistant subpopulations and their ability to persist without selective antibiotic pressure, complicating treatment outcomes. The research shows that Tgc-HR is linked to multiple resistance and virulence factors, suggesting a co-evolution of resistance and pathogenicity. This finding underscores the importance of monitoring for heteroresistance in clinical settings, as it may lead to undetected therapeutic failures. Additionally, the study contributes to understanding the role of plasmids in the spread of resistance, emphasizing the need for comprehensive genomic surveillance to inform better antimicrobial strategies.