Antimicrobial Resistance in Bacteria: Mechanisms, Evolution, and Persistence

• Published in: Journal of molecular evolution 2020-01, Vol.88 (1), p.26-40
• Main Authors: Christaki, Eirini, Marcou, Markella, Tofarides, Andreas
• Format: Article
• Language: English
• Subjects: Animal Genetics and Genomics; Anti-Bacterial Agents - pharmacology; Anti-Infective Agents - pharmacology; Antibiotics; Antiinfectives and antibacterials; Antimicrobial agents; Antimicrobial resistance; Bacteria; Bacteria - genetics; Biological Evolution; Biomedical and Life Sciences; Cell Biology; Drug resistance; Drug Resistance, Bacterial - drug effects; Drug Resistance, Bacterial - genetics; Drug Resistance, Microbial - drug effects; Drug Resistance, Microbial - genetics; Evolution; Evolution, Molecular; Evolutionary Biology; Humans; Life Sciences; Microbiology; Multidrug resistance; Phenotypes; Plant Genetics and Genomics; Plant Sciences; Review; Therapeutic applications
• ISSN: 0022-2844; 1432-1432
• DOI: 10.1007/s00239-019-09914-3

In recent years, we have seen antimicrobial resistance rapidly emerge at a global scale and spread from one country to the other faster than previously thought. Superbugs and multidrug-resistant bacteria are endemic in many parts of the world. There is no question that the widespread use, overuse, and misuse of antimicrobials during the last 80 years have been associated with the explosion of antimicrobial resistance. On the other hand, the molecular pathways behind the emergence of antimicrobial resistance in bacteria were present since ancient times. Some of these mechanisms are the ancestors of current resistance determinants. Evidently, there are plenty of putative resistance genes in the environment, however, we cannot yet predict which ones would be able to be expressed as phenotypes in pathogenic bacteria and cause clinical disease. In addition, in the presence of inhibitory and sub-inhibitory concentrations of antibiotics in natural habitats, one could assume that novel resistance mechanisms will arise against antimicrobial compounds. This review presents an overview of antimicrobial resistance mechanisms, and describes how these have evolved and how they continue to emerge. As antimicrobial strategies able to bypass the development of resistance are urgently needed, a better understanding of the critical factors that contribute to the persistence and spread of antimicrobial resistance may yield innovative perspectives on the design of such new therapeutic targets.