Combinatorial approach of bacteria to antibiotic resistance

In this minireview, we will consider the combinatorial genetics bacteria use to offset antibiotic selective pressure, i.e., resistance gene associations, organization, and regulation. The quantitative and qualitative consequences of this gene shuffling will be discussed in terms of phenotype. For the sake of simplicity, we will concentrate on Gram-positive cocci (enterococci, streptococci, and staphylococci) of medical importance and on antibiotic classes which are therapeutically relevant. The data provided are mainly, if not exclusively, taken from the work carried out in the laboratory, although there are numerous other examples in the literature.