Chapter 6 : Antibiotic Resistance and Survival in the Host

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The alarming increase in the number of multidrug-resistant microorganisms isolated in both clinical and nonclinical settings over the past decade parallels the rise in antibiotic use and exemplifies these adaptive abilities. Current antibiotic drugs target a variety of cellular processes and result in cell stasis or death through inhibition of protein, RNA or DNA synthesis, disruption of permeability barriers, or inhibition of cell wall peptidoglycan biosynthesis. Many drugs passively diffuse across the cytoplasmic membranes of both gram-positive and -negative bacteria. Bacteria possess certain intrinsic properties that provide natural resistance to some classes of antibiotics. Modifying or hydrolytic enzymes provide bacteria with a method of neutralizing certain drugs that have gained access to the cell. The nature of modern medicine dictates that, at some point, all pathogenic bacteria will encounter antimicrobials; thus, resistance will inevitably arise (possibly based on host-defense evasion mechanisms). Decreased exotoxin production may also contribute to the ability of these variants to evade host defenses and to their increased resistance to antibiotics in vivo. Biofilms are inherently resistant to both antibiotics and host defenses. Production of mature biofilms involves a complex regulatory pathway. Two-component regulatory systems provide bacteria with a way to integrate regulation of expression of virulence factors and antibiotic resistance into their general stress response pathways.

Citation: Macfarlane E, Hancock R. 2000. Antibiotic Resistance and Survival in the Host, p 93-104. In Brogden K, Roth J, Stanton T, Bolin C, Minion F, Wannemuehler M (ed), Virulence Mechanisms of Bacterial Pathogens, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818111.ch6

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Bacterial Diseases
Outer Membrane Proteins
Electron Transport System
Mobile Genetic Elements
Type IV Pili
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Schematic diagram summarizing the functions and interactions of the PhoP-PhoQ twocomponent regulatory system in serovar Typhimurium.

Citation: Macfarlane E, Hancock R. 2000. Antibiotic Resistance and Survival in the Host, p 93-104. In Brogden K, Roth J, Stanton T, Bolin C, Minion F, Wannemuehler M (ed), Virulence Mechanisms of Bacterial Pathogens, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818111.ch6
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Generic image for table

Major classes of antibiotics in current medical use

Citation: Macfarlane E, Hancock R. 2000. Antibiotic Resistance and Survival in the Host, p 93-104. In Brogden K, Roth J, Stanton T, Bolin C, Minion F, Wannemuehler M (ed), Virulence Mechanisms of Bacterial Pathogens, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818111.ch6

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