title: The potential impact of coinfection on antimicrobial chemotherapy and drug resistance.
abstract: Across a range of pathogens, resistance to chemotherapy is a growing problem in both public health and animal health. Despite the ubiquity of coinfection, and its potential effects on within-host biology, the role played by coinfecting pathogens on the evolution of resistance and efficacy of antimicrobial chemotherapy is rarely considered. In this review, we provide an overview of the mechanisms of interaction of coinfecting pathogens, ranging from immune modulation and resource modulation, to drug interactions. We discuss their potential implications for the evolution of resistance, providing evidence in the rare cases where it is available. Overall, our review indicates that the impact of coinfection has the potential to be considerable, suggesting that this should be taken into account when designing antimicrobial drug treatments.
authors.affiliation: Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.
authors.forename: Ruthie B
authors.initials: RB
authors.lastname: Birger
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.|Institute of Medical Virology, University of Zürich, Zürich, Switzerland.
authors.forename: Roger D
authors.initials: RD
authors.lastname: Kouyos
authors.affiliation: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
authors.forename: Ted
authors.initials: T
authors.lastname: Cohen
authors.affiliation: Department of Entomology, Gardner Hall, Derieux Place, North Carolina State University, Raleigh, NC 27695-7613, USA.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Griffiths
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic -Universitat de Barcelona, Barcelona, Spain.
authors.forename: Silvie
authors.initials: S
authors.lastname: Huijben
authors.affiliation: Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.|Medical Scientist Training Program, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mina
authors.affiliation: Department of Diagnostic Medicine/Pathobiology, Institute of Computational Comparative Medicine, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA.
authors.forename: Victoriya
authors.initials: V
authors.lastname: Volkova
authors.affiliation: Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.|Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Grenfell
authors.affiliation: Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.|Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
authors.forename: C Jessica E
authors.initials: CJE
authors.lastname: Metcalf
mesh_terms: D000818:Animals; D060085:Coinfection / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology* / Q000469:parasitology; D004352:Drug Resistance, Microbial / Q000235:genetics; D054884:Host-Pathogen Interactions; D006801:Humans; D007155:Immunologic Factors / Q000502:physiology; D056265:Microbial Interactions; D008954:Models, Biological
chemical_list: D007155:Immunologic Factors
keywords: coinfection; drug resistance; immune modulation; parasite interactions; resource competition