David Weiss PhD
Overview
Antibiotic resistance is one of the worlds greatest medical challenges, threatening medicine as we know it. Without reliable antibiotics, transplants, cancer chemotherapy, and many surgeries would not be considered safe. Even routine accidents leading to infections could be lethal.
Our labs research is largely focused on understanding mechanisms of antibiotic resistance and developing novel therapeutic approaches to combat drug-resistant bacteria. A major area of interest is elucidating the factors controlling heteroresistance, a phenomenon in which a minor subpopulation of cells exhibits phenotypic resistance and co-exists with a majority susceptible population. We discovered that the minor resistant subpopulation of cells can cause in vivo antibiotic treatment failure. If the frequency of the resistant subpopulation is especially low (<1 in 10,000 cells), isolates are often incorrectly classified as susceptible by current diagnostic tests, potentially leading clinicians to inadvertently use ineffective antibiotics.
Surprisingly, we determined that heteroresistance can be exploited as a bacterial Achilles heel and the basis of effective combination therapies. When combined, two antibiotics to which a given strain is heteroresistant eradicate the bacteria as each drug kills the subpopulation of cells resistant to the other. This approach can even eradicate strains classified as pan-resistant and has been used in real-time to effectively treat several patients infected with such infections.
Heteroresistance is broadly found in all bacteria we have studied thus far. We now focus mainly on Gram-negative bacterial pathogens including carbapenem-resistant Enterobacterales (CRE; such as Klebsiella and Enterobacter species), Acinetobacter baumannii and Pseudomonas aeruginosa. Overall, our translational research program combines basic research on mechanisms of antibiotic resistance and bacterial pathogenesis with epidemiological and clinical studies to make novel insights leading to new clinical interventions.
Background
Dr. Weiss received his PhD in Microbiology from New York University in 2004. Working under Dr. Arturo Zychlinsky, he studied how Toll-like Receptors work together to fight bacterial infections. He completed his postdoctoral training at Stanford University under Drs. Stanley Falkow and Denise Monack, studying virulence mechanisms of Francisella and the role of the inflammasome in host defense. He was the recipient of a three-year postdoctoral fellowship from the Giannini Family Foundation and is currently a Burroughs Wellcome Fund Investigator in the Pathogenesis of Infectious Disease.
Academic Appointment
- Associate Professor, Division of Infectious Diseases, Emory University School of Medicine
Education
Degrees
- PhD from New York University School of Medicine
- BS from Brandeis University
Research
Publications
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Lineage-dependent variations in single-cell antibiotic susceptibility reveal the selective inheritance of phenotypic resistance in bacteria.
Nat Commun Volume: 16 Page(s): 4655
05/19/2025 Authors: Stine W; Akiyama T; Weiss D; Kim M -
Zinc-dependent -lactam resistance at a cost.
Nat Microbiol Volume: 10 Page(s): 4 - 5
01/01/2025 Authors: Choby JE; Weiss DS -
Bactericidal antibiotic treatment induces damaging inflammation via TLR9 sensing of bacterial DNA.
Nat Commun Volume: 15 Page(s): 10359
11/28/2024 Authors: Gross JL; Basu R; Bradfield CJ; Sun J; John SP; Das S; Dekker JP; Weiss DS; Fraser IDC -
Antifungal heteroresistance causes prophylaxis failure and facilitates breakthrough Candida parapsilosis infections.
Nat Med Volume: 30 Page(s): 3163 - 3172
11/01/2024 Authors: Zhai B; Liao C; Jaggavarapu S; Tang Y; Rolling T; Ning Y; Sun T; Bergin SA; Gjonbalaj M; Miranda E -
Theoretical considerations and empirical predictions of the pharmaco- and population dynamics of heteroresistance.
Proc Natl Acad Sci U S A Volume: 121 Page(s): e2318600121
04/16/2024 Authors: Levin BR; Berryhill BA; Gil-Gil T; Manuel JA; Smith AP; Choby JE; Andersson DI; Weiss DS; Baquero F -
Heteroresistance to piperacillin/tazobactam in Klebsiella pneumoniae is mediated by increased copy number of multiple -lactamase genes.
JAC Antimicrob Resist Volume: 6 Page(s): dlae057
04/01/2024 Authors: Babiker A; Lohsen S; Van Riel J; Hjort K; Weiss DS; Andersson DI; Satola S -
Heteroresistance is a cause of discrepant antibiotic susceptibility testing results.
Lancet Microbe Volume: 5 Page(s): e312
04/01/2024 Authors: Ozturk T; Weiss DS -
Discordant antimicrobial susceptibility and polymerase chain reaction (PCR) testing in a Klebsiella pneumoniae isolate with a carbapenemase gene.
Infect Control Hosp Epidemiol Volume: 44 Page(s): 2100 - 2102
12/01/2023 Authors: Witt LS; Page A; Burd EM; Ozturk T; Weiss DS; Ray SM; Satola S; Gottlieb LB -
Fecal microbiota transplantation promotes reduction of antimicrobial resistance by strain replacement.
Sci Transl Med Volume: 15 Page(s): eabo2750
11/01/2023 Authors: Woodworth MH; Conrad RE; Haldopoulos M; Pouch SM; Babiker A; Mehta AK; Sitchenko KL; Wang CH; Strudwick A; Ingersoll JM -
Theoretical Considerations and Empirical Predictions of the Pharmaco- and Population Dynamics of Heteroresistance.
bioRxiv
10/24/2023 Authors: Levin BR; Berryhill BA; Gil-Gil T; Manuel JA; Smith AP; Choby JE; Andersson DI; Weiss DS; Baquero F