General mechanisms of resistance to antibiotics

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Abstract
Resistance to antimicrobial agents may result from intrinsic properties of organisms, through mutation and through plasmid- and transposon-specified genes. ß-Lactam resistance is most frequently associated with one or more chromosomal- or plasmid-specified ß-lactamases. Recently, mutations modifying penicillin-binding proteins have been detected with increased frequency as a cause of ß-lactam resistance. Mixed mechanisms, reduced permeability and tolerance are other causes of resistance. Aminoglycoside resistance always involves some modification of drug uptake, most often due to a variety of enzymes modifying these compounds. Reduced uptake is a primary cause of resistance in anaerobic bacteria and bacteria growing anaerobically, some strains of Pseudomonas aeruginosa, and mutants that arise during antimicrobial therapy and are defective in energy-generation systems. Resistance to other antimicrobial agents is presented in tabular form.

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