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Multidrug resistance in bacteria

Hiroshi Nikaido1

  • 1Department of Molecular and Cell Biology, University of California, Berkeley, CA 94720-3202, USA. nhiroshi@berkeley.edu

Annual Review of Biochemistry
|February 24, 2009
PubMed

Insights

Widespread antibiotic use drives multidrug resistance in pathogenic bacteria. This occurs through gene accumulation on resistance plasmids or increased expression of efflux pumps, mechanisms detailed in this review.

Area of Science:

  • Microbiology
  • Molecular Biology
  • Pharmacology

Background:

  • Extensive antibiotic application in human medicine, agriculture, and aquaculture has led to the emergence of multidrug-resistant (MDR) bacteria.
  • Pathogenic bacteria accumulating resistance to multiple drugs pose a significant global health threat.

Purpose of the Study:

  • To review the molecular mechanisms underlying bacterial multidrug resistance.
  • To provide an overview of current knowledge on how bacteria develop resistance to various antibiotics.

Main Methods:

  • Literature review of scientific articles on bacterial resistance mechanisms.
  • Analysis of genetic and molecular pathways conferring multidrug resistance.

Main Results:

  • Multidrug resistance arises from two primary mechanisms: acquisition of multiple single-drug resistance genes, often via resistance (R) plasmids, and enhanced expression of multidrug efflux pumps.
  • Resistance (R) plasmids facilitate the accumulation of diverse resistance genes within a single bacterial cell.
  • Multidrug efflux pumps actively extrude a broad spectrum of antibiotics from bacterial cells.

Conclusions:

  • Understanding these molecular mechanisms is crucial for developing strategies to combat antibiotic resistance.
  • The review highlights the dual nature of MDR generation, emphasizing both genetic acquisition and functional protein-mediated resistance.

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