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Published on: May 2, 2018
Antimicrobial Resistance in Bacteria: Mechanisms, Evolution, and Persistence
Eirini Christaki1,2, Markella Marcou3,4, Andreas Tofarides5
1Medical School, University of Cyprus, Nicosia, Cyprus. christaki.eirini@ucy.ac.cy.
Abstract:
In recent years, we have seen antimicrobial resistance rapidly emerge at a global scale and spread from one country to the other faster than previously thought. Superbugs and multidrug-resistant bacteria are endemic in many parts of the world. There is no question that the widespread use, overuse, and misuse of antimicrobials during the last 80 years have been associated with the explosion of antimicrobial resistance. On the other hand, the molecular pathways behind the emergence of antimicrobial resistance in bacteria were present since ancient times. Some of these mechanisms are the ancestors of current resistance determinants. Evidently, there are plenty of putative resistance genes in the environment, however, we cannot yet predict which ones would be able to be expressed as phenotypes in pathogenic bacteria and cause clinical disease. In addition, in the presence of inhibitory and sub-inhibitory concentrations of antibiotics in natural habitats, one could assume that novel resistance mechanisms will arise against antimicrobial compounds. This review presents an overview of antimicrobial resistance mechanisms, and describes how these have evolved and how they continue to emerge. As antimicrobial strategies able to bypass the development of resistance are urgently needed, a better understanding of the critical factors that contribute to the persistence and spread of antimicrobial resistance may yield innovative perspectives on the design of such new therapeutic targets.
Insights
Antimicrobial resistance is a growing global threat due to widespread antimicrobial use. Understanding the evolution of resistance mechanisms is crucial for developing new strategies against superbugs.
Area of Science:
- Microbiology
- Evolutionary Biology
- Public Health
Background:
- Antimicrobial resistance (AMR) is a significant global health crisis, with multidrug-resistant bacteria becoming increasingly prevalent worldwide.
- The extensive use, overuse, and misuse of antimicrobials over the past 80 years have significantly contributed to the rapid emergence and spread of AMR.
- Ancient molecular pathways and environmental resistance genes represent ancestral mechanisms that can evolve into modern resistance determinants.
Purpose of the Study:
- To provide a comprehensive overview of the diverse mechanisms underlying antimicrobial resistance in bacteria.
- To explore the evolutionary history and ongoing emergence of these resistance mechanisms.
- To highlight the need for novel antimicrobial strategies by understanding factors driving AMR persistence and spread.
Main Methods:
- This review synthesizes existing scientific literature on antimicrobial resistance mechanisms.
- It examines the evolutionary trajectory of resistance determinants from ancient origins to contemporary clinical challenges.
- The review analyzes the role of environmental factors, including sub-inhibitory antibiotic concentrations, in fostering novel resistance.
Main Results:
- Antimicrobial resistance mechanisms have ancient roots and are continuously evolving.
- Environmental reservoirs harbor numerous potential resistance genes, though their expression in pathogenic bacteria remains unpredictable.
- Exposure to antibiotics, even at sub-inhibitory levels, can drive the emergence of new resistance strategies.
Conclusions:
- A deeper understanding of AMR evolution and spread is essential for combating the global health threat posed by superbugs.
- Identifying critical factors influencing AMR persistence can inform the development of innovative therapeutic targets.
- New antimicrobial strategies are urgently needed to circumvent existing and emerging resistance mechanisms.
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