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Antibiotic-recalcitrant Salmonella during infection

Nature Reviews Microbiology volume 23, pages 276–287 (2025)Cite this article

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Abstract

Antibiotic-recalcitrant infections, defined as the prolonged carriage of pathogenic bacteria even in the presence of antibiotics, are often caused by bacteria that are genetically susceptible to the drug. These recalcitrant bacteria fail to proliferate in the presence of antibiotics but remain viable such that they may recolonize their niche following antibiotic withdrawal. Significant progress has been made in our understanding of antibiotic-recalcitrant Salmonella, which are thought to be the source of infection relapse. In recent years, it has been shown that recalcitrant bacteria manipulate host immune defences and could directly contribute to the spread of antimicrobial resistance. In this Review, we provide an overview of what is currently known about the antibiotic recalcitrance of Salmonella during infection and highlight knowledge gaps requiring additional research in the future.

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Fig. 1: Bacterial mechanisms of antibiotic evasion.
Fig. 2: Intramacrophage persister physiology.
Fig. 3: Salmonella dissemination patterns in the murine model of systemic infection.
Fig. 4: Outcomes and implications of recalcitrant Salmonella infection.

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  1. Department of Microbiology, Harvard Medical School, Boston, MA, USA

    Rachel T. Giorgio & Sophie Helaine

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  1. Rachel T. Giorgio
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  2. Sophie Helaine
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R.T.G. researched data for the manuscript. R.T.G. and S.H. discussed, wrote and edited the manuscript.

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Giorgio, R.T., Helaine, S. Antibiotic-recalcitrant Salmonella during infection. Nat Rev Microbiol 23, 276–287 (2025). https://doi.org/10.1038/s41579-024-01124-z

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