Bridging the gap between viable but non-culturable and antibiotic persistent bacteria

• Persisters and viable but non-culturable (VBNC) cells are both able to tolerate high-dose antibiotics.
• Persisters and VBNC cells are induced by common environmental cues.
• Persisters and VBNC cells share molecular mechanisms that control dormancy.
• Persisters and VBNC cells are likely closely related and develop through shared mechanisms.

Microbial dormancy is a widespread phenomenon employed by bacteria to evade environmental threats including antibiotics. This intrinsic mechanism of antibiotic tolerance has drawn special attention to the role of dormancy in human disease, particularly in regards to recurrent infections. Two dormancy states, the viable but non-culturable state and bacterial persistence, both produce antibiotic-tolerant populations capable of withstanding prolonged lethal treatment. Currently described as two distinct forms of dormancy, they are rarely discussed in the same context. We argue here that these two dormant states are closely related phenomena which are part of a shared ‘dormancy continuum’. This discussion is intended to stimulate discourse about these seemingly different but very similar dormant states.