Dynamic growth trajectories distinguish bacteriostatic and bactericidal antibiotics at subinhibitory concentrations
Elizabeth VaisbourdiD, David S. GlassiD, Yifan YangiD, Avi MayoiD, A. Bren, Uri S. AloniD
Abstract
Subinhibitory antibiotic exposures are common in clinical and environmental contexts, yet their effects on bacterial growth dynamics remain incompletely understood. We studied the temporal response of Escherichia coli to a panel of bactericidal ("cidal") and bacteriostatic ("static") antibiotics at sub-minimum inhibitory concentrations (sub-MIC). We uncover a sharp dynamical distinction between the two classes. Bacteriostatic antibiotics reduce the initial growth rate in a dose-dependent manner, similar to a nutrient starvation response. In contrast, bactericidal antibiotics do not alter initial growth rates - cells continue to grow as fast as untreated cells - until an abrupt slowdown in growth rate. The onset of slowdown occurs earlier with increasing dose, suggesting a damage accumulation mechanism leading to a lethal threshold. Cidals also show a steeper dose-response curve. We propose that bacteria respond to cidal antibiotics with a "grow-fast-then-crash" strategy that is adaptive for transient lethal threats, whereas static antibiotics trigger stress adaptation and slower growth. While clinical outcomes of statics and cidals may be similar at full inhibitory doses, these sub-MIC dynamical signatures could influence resistance evolution and treatment outcomes in biofilms or partially resistant strains. Our findings offer a dynamic framework for antibiotic classification and raise new questions about how bacteria respond to sublethal antibiotic stress.
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