Treatment of Mycobacterium tuberculosis infections is complicated by the need for a prolonged course of antibiotics to fully eliminate all the bacteria present in an infected individual. Most antibiotics target growth and division machinery; thus, Aldridge et al. (p. 100, published online 15 November) postulated that heterogeneity in the growth properties of mycobacterial cells underlies variable antibiotic susceptibility. Cell division in mycobacteria was found to be asymmetrical, with one cell inheriting the growing pole and elongating rapidly, while the other cell elongated more slowly. Over multiple cell divisions, the rapidly growing cells became more susceptible to antibiotic treatment, helping to explain the observed heterogeneity in response to antibiotic therapy.
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