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Resistance mechanisms in Gram-negative bacteria
J A Lepe1, L Martínez-Martínez2
1Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla/CSIC/Hospital Universitario Virgen del Rocío, Sevilla, Spain; Departamento de Microbiología, Universidad de Sevilla, Sevilla, Spain.
Medicina Intensiva
|June 6, 2022
Summary
Multidrug-resistant bacteria, including carbapenem-resistant Enterobacterales and non-fermenters, pose a critical threat. This review details their resistance mechanisms against key antibiotics, guiding new antimicrobial development.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- The World Health Organization identifies carbapenem-resistant Enterobacterales and non-fermenters as critical priorities due to widespread antimicrobial resistance.
- These pathogens resist common clinical antimicrobials, necessitating urgent research into novel treatment strategies.
Purpose of the Study:
- To review the primary resistance mechanisms employed by key Gram-negative bacteria against major antibiotic classes.
- To provide updated information on antimicrobial resistance mechanisms relevant to clinical practice and drug development.
Main Methods:
- Literature review focusing on resistance mechanisms in Enterobacterales, Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia.
- Analysis of scientific literature detailing antimicrobial modification, permeability alterations, efflux pumps, target changes, and two-component systems.
Main Results:
- Detailed examination of resistance to β-lactams, quinolones, aminoglycosides, and polymyxins.
- Updated insights into antimicrobial modification enzymes (e.g., carbapenemases, ESBLs, aminoglycoside-modifying enzymes).
- Discussion of the roles of porin/LPS alterations, efflux pumps, target modifications, and two-component systems in conferring resistance.
Conclusions:
- Understanding these diverse resistance mechanisms is crucial for combating challenging Gram-negative infections.
- This review provides a foundation for developing new antimicrobial agents and strategies against priority pathogens.
Keywords:
Acinetobacter baumanniiAntimicrobial agentsAntimicrobianosEnterobacteralesEnterobacteriasPseudomonas aeruginosaResistanceResistenciaStenotrophomonas maltophiliaMore Related Videos
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