Anti-Microbial Resistance

Antimicrobial agents play a key role in controlling and curing infectious disease. Soon after the discovery of the first antibiotic, the challenge of antibiotic resistance commenced.


Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and fatal in some cases.

 

Bacteria are endlessly using methods to overcome the effectivity of the antibiotics by using distinct types of mechanisms. Comprehending the mechanisms of resistance is vital for better understanding and to continue use of current antibiotics. Which also helps to formulate synthetic antimicrobials to overcome the current mechanism of resistance. Also, encourage in prudent use and misuse of antimicrobial agents. Thus, decline in treatment costs and in the rate of morbidity and mortality.​

Anti-Microbial Resistance

Reference:

Mechanisms for Acquired by the microorganisms for antimicrobial resistance
  • Production of drug-inactivating enzymes

  • Modification of an existing antibiotic targets

  • Acquisition of a target by-pass system – alternative metabolic pathways

  • Reduced cell permeability – restricting antimicrobial access to target sites

  • Drug removal from the cell

  • Degradation of the antimicrobial agent,

  • Overproduction of the target enzyme

Clinical implications of AMR

  • Antimicrobial resistance hinders the effective treatment of a range of health conditions caused by bacteria, fungus, and virus.

  • The success of chemotherapy for cancer, organ transplantations, and even minor dental surgeries would be compromised without the novel drugs. 

  • The emergence of new resistant mechanisms within the bacteria threatens our ability in treating common diseases like typhoid, flu, and this will result in prolonged illness and treatment, permanent disability or even death.

  • Mandatory prolonged treatment and the need for expensive drugs in antibiotic-resistant patients results in higher health care costs than their counterparts.

Antibiotics

Mode of action

Beta - Lactams

Aminoglycosides

Chloramphenicol

Glycopeptides

Quinolones

Oxazolidinones

Sulfonamides

Tetracyclines

Macrolides

Ansamycins

Streptogramins

Inhibit bacterial cell wall biosynthesis

Lipopeptides

Disrupt multiple cell membrane functions, leading to cell death 

Inhibit protein synthesis by bacteria leading to cell death

Inhibit RNA synthesis by bacteria leading to cell death

Inhibit protein synthesis, preventing growth and some cases leading to cell death

Inhibit protein synthesis, preventing growth 

Bacteriostatic action – prevent growth and multiplication

Inhibit protein synthesis, preventing the growth 

Interfere in bacterial DNA replication and transcription 

Inhibit bacterial cell wall biosynthesis 

Inhibit protein synthesis, preventing growth 

Inhibit protein synthesis by bacteria leading to cell death

Colistin Resistance 

  • Mcr-1

Vancomycin Resistance 

  • vanA/B

  • ESBL

  • CTX-M

 

Methicilin Resistance 

  • MecA/C

  • MecA/C and MREJ (MRSA)

Carbapenems

  • IMP

  • KPC

  • OXA-48

  • NDM

  • VIM

Cephalosporins

  • blaCTX-M

  • blaTEM 

  • blaSHV

  • blaCMY-2

Genes responsible for AMR

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