Antibiotic resistance can come at a high cost, both in terms of fitness for the pathogen and poorer outcomes for patients. The fitness landscape encountered by bacterial pathogens varies greatly throughout patient populations in terms of host immunity as well as the duration and spectrum of antibiotics encountered. Severely immunocompromised patients present a favorable environment for antibiotic resistance to emerge due to lack of immune-mediated competition and increased opportunities to evolve both on-target and compensatory mutations. Such patients may present unique pathways for antibiotic resistance to emerge.

中文翻译：

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免疫功能受损的健身环境有利于抗生素耐药性的出现。

从对病原体的适应性和对患者的不良结果来看，抗生素耐药性的代价都很高。就宿主免疫力以及所遇到抗生素的持续时间和范围而言，细菌病原体所遇到的适应状况在整个患者人群中差异很大。由于缺乏免疫介导的竞争以及出现靶点和代偿性突变的机会增加，严重免疫受损的患者为出现抗生素耐药性提供了有利的环境。此类患者可能会呈现出独特的抗生素耐药性出现途径。