Clinical implications of polymicrobial synergism effects on antimicrobial susceptibility

William Little, Caroline Black, Allie Clinton Smith

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations


With the development of next generation sequencing technologies in recent years, it has been demonstrated that many human infectious processes, including chronic wounds, cystic fibrosis, and otitis media, are associated with a polymicrobial burden. Research has also demonstrated that polymicrobial infections tend to be associated with treatment failure and worse patient prognoses. Despite the importance of the polymicrobial nature of many infection states, the current clinical standard for determining antimicrobial susceptibility in the clinical laboratory is exclusively performed on unimicrobial suspensions. There is a growing body of research demonstrating that microorganisms in a polymicrobial environment can synergize their activities associated with a variety of outcomes, including changes to their antimicrobial susceptibility through both resistance and tolerance mechanisms. This review highlights the current body of work describing polymicrobial synergism, both inter-and intra-kingdom, impacting antimicrobial susceptibility. Given the importance of polymicrobial synergism in the clinical environment, a new system of determining antimicrobial susceptibility from polymicrobial infections may significantly impact patient treatment and outcomes.

Original languageEnglish
Article number144
Pages (from-to)1-12
Number of pages12
Issue number2
StatePublished - Feb 2021


  • Antimicrobial susceptibility
  • Clinical
  • Diagnostics
  • Interactions
  • Polymicrobial
  • Synergism


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