Mechanisms of Resistance in Bacteria: An Evolutionary Approach



Ana Martins 1, 2, Attila Hunyadi 3, 4, Leonard Amaral*, 1, 5, 6
1 Unidade de Parasitologia e Microbiologia Médica, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira 100, 1349-008 Lisboa, Portugal
2 Institute of Medical Microbiology and Immunobiology, Faculty of Medicine, University of Szeged, Dóm Tér 10, 6720 Szeged, Hungary
3 Institute of Pharmacognosy, Faculty of Pharmacy, University of Szeged, Eötvös u. 6, 6720 Szeged, Hungary
4 COST Action CM0804 of the European Commission/European Science Foundation, Brussels, Belgium
5 Centro de Malária e Doenças Tropicais (CMDT), Instituto de Higiene e Medicina Tropical, Universidade Nova de Lis-boa, Rua da Junqueira 100, 1349-008 Lisboa, Portugal
6 COST Action BM0701 of the European Commission/European Science Foundation, Brussels, Belgium


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© Martins et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira 100, 1349-008 Lisboa, Portugal; Tel: +351213652600; E-mail: lamaral@ihmt,unl.pt


Abstract

Acquisition of resistance is one of the major causes of failure in therapy of bacterial infections. According to the World Health Organization (WHO), thousands of deaths caused by Salmonella sp., Escherichia coli, Staphylococcus aureus or Mycobacteria tuberculosis are due to failure in therapy caused by resistance to the chemotherapeutic agents. Understanding the mechanisms of resistance acquisition by the bacterial strains is therefore essential to prevent and overcome resistance. However, it is very difficult to extrapolate from in vitro studies, where the variables are far less and under constant control, as compared to what happens in vivo where the chosen chemotherapeutic, its effective dose, and the patient’s immune system are variables that differ substantially case-by-case. The aim of this review is to provide a new perspective on the possible ways by which resistance is acquired by the bacterial strains within the patient, with a special emphasis on the adaptive response of the infecting bacteria to the administered antibiotic.

Keywords:: Multi-drug resistance, acquisition of resistance, efflux pumps.