Impact of bacterial persisters on their host

•Persisters are antibiotic tolerant bacteria described in vitro but also seen in the infected host.•Animal models reveal that persisters in the host withstand prolonged antibiotic treatment.•There is pressing need to determine the extent of persister contribution to infection relapse.•Persisters have a role in AMR evolution and host manipulation. The rise of antibiotic failure poses a severe threat to global health. There is growing concern that this failure is not solely driven by stable antibiotic resistance but also by a subpopulation of transiently non-growing, antibiotic tolerant bacteria. These ‘persisters’ have been proposed to seed relapsing infections, an important clinical outcome of treatment failure — although definitive evidence for this direct link remains elusive. Recent advances in the field have revealed the complex nature of intra-host persisters which drive their high adaptability through biosynthetic activity. These features of persisters contribute to evolution of antimicrobial resistance and modulation of host immune responses, despite clinically efficacious treatment.