Heteroresistance is a phenomenon where a subset of bacterial cells shows higher resistance towards antibiotic while the majority are susceptible to the same. Till date, a few reports have been emerged with prevalence of heteroresistance in several bacterial species towards different classes of antibiotics. It is hard to treat heteroresistant bacterial infections as it is difficult in identifying and studying these subpopulations. The organisms with stable heteroresistance can sustain the resistance ability even in the absence of antibiotics while unstable heteroresistance can revert to susceptibility in the absence of antibiotics. The bacterial heteroresistance is due to genetically unsteady amplification of tandem genes or could also be due to physiological mechanism. The major challenge is to detect and distinguish isolates into susceptible or resistant to antibiotics due to instability and low frequency in their appearance that can give misinterpretation in the therapy. This review concentrates on bacterial heteroresistance with their associated mechanisms followed by modified and advanced evaluation procedures. Also, complications allied with the treatment failure due to bacterial heteroresistance and concerns over its prevalence in food chain.

异抗性是一种现象，其中一部分细菌细胞对抗生素表现出更高的耐药性，而大多数细胞对抗生素敏感。迄今为止，已经出现了一些报告，表明几种细菌物种对不同类别的抗生素普遍存在异种耐药性。由于很难识别和研究这些亚群，因此很难治疗异种耐药性细菌感染。具有稳定异抗性的生物即使在没有抗生素的情况下也能保持抗药性，而不稳定的异抗性在没有抗生素的情况下可以恢复为易感性。细菌异源抗性是由于串联基因的遗传不稳定扩增或也可能是由于生理机制。主要的挑战是检测分离株并将其区分为对抗生素敏感或耐药，因为它们的外观不稳定和频率低，可能会在治疗中产生误解。本综述主要关注细菌异种抗性及其相关机制，然后是改进和先进的评估程序。此外，由于细菌异种耐药性和对其在食物链中的流行的担忧，并发症与治疗失败有关。