General Modes Of Resistance

Antibiotic resistance mechanisms fall into various categories for both resistance to specific antibiotics and for multidrug resistance.[1,2] In general, the mechanisms for resistance to specific antibiotics include: 1) mutations that prevent the antibiotic from affecting the target, 2) porins or other cytoplasmic membrane proteins that actively pump the antibiotic out of the cell, 3) enzymatic inac-tivation of the antibiotic, 4) modification or protection of the antibiotic target, 5) circumvention of the effects of the antibiotic, and 6) failure to activate the antibiotic. The mechanisms used for multidrug resistance include: 1) efflux pumps in the cytoplasmic membrane that actively pump multiple antibiotics out of the cell, 2) alterations to the cytoplasmic membrane or cell wall such that the antibiotics do not enter the cell, and 3) formation of protective biofilms that restrict exposure of the microbes to antibiotics.

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