Cracking bacterial persisters: from molecular mechanisms and host adaptation to novel methodologies and countermeasures

Persisters represent phenotypic tolerance characterized by a MIC value within the susceptible range, along with reduced metabolic activity marked by ATP depletion, a feature likely implicated in persistent and recurrent infections. Although prior research has addressed certain issues associated with persisters, the latest research advances spanning from bacterial physiology to host-pathogen interactions are lacking. Therefore, this review aims to elucidate the definition, distinction, formation mechanisms, host-pathogen adaptation, novel methodologies, and eradication strategies related to bacterial persistence, while highlighting recent advances and prospects pertinent to bacterial persistence. This review seeks to consolidate extant knowledge as a foundational resource for mechanistic and intervention studies and inspire innovative approaches to combat persistent infections.