Antibiotic resistance multiple drug

Finally, some gram-negative organisms demonstrate a fourth mechanism of resistance. For example, strains of P. aeruginosa produce xenobiotic efflux pumps to eject antibiotics. Drug efflux mechanisms are associated with multiple drug resistance, including resistance to (3-lactam antibiotics. 

Davies J. and C.E. Amabile-Cuevas (2003). The Rise of Antibiotic Resistance. In C.F. Amabile-Cuevas (Ed.). Multiple Drug Resistant Bacteria. Horizon Scientific Press, Wymondham, UK, pp. 1-7. 

Threlfall E.J., L.R. Ward, J.A. Skinner, and B. Rowe (1997). Increase in multiple antibiotic resistance in nontyphoidal Salmonella from humans in England and Wales A comparison of data for 1994 and 1996. Microbial Drug Resistance 3 263-266. 

The need for new antibiotics is driven by the recent rise in the incidence of resistance to commonly used antibiotics. The emergence of multiple-drug resistance to community-acquired infections, such as those caused by Streptococcus pneumoniae, is particularly alarming due to the ease of transmission [1-4], Recent reports show that methicillin-resistant Staphylococcus aureus, the common cause of hospital-acquired infections, has also moved into the community [5],... 

On the other hand, depsides are peptide analogs entirely build up by hydroxyl acids mutually connected through ester bonds. A representative example of depsides is the naturally occurring macrotetralide antibiotic nonactin (63). Nonactin has been shown to possess activity against the P170-glycoprotein efflux pump associated with multiple drug-resistant cancer cells. 

Studies by the Upjohn group confirmed the potent activity of nargenicin Ai against multiple-drug resistant strains of S. aureus and demonstrated the in vivo activity of the antibiotic in mice (Table 3)7... 

Capreomycin. — Because of low toxicity and remarkable activity against drug-resistant strains of M. tuberculosis, capreomycin, a polypeptide antibiotic, was recommended for use in multiple-drug therapy... 

Multiple-antibiotic-resistant enterococci—Many Enterococcus spp. are now resistant to penicillin and ampi-cillin, gentamicin or streptomycin or both, and to vancomycin. Some of these strains are snsceptible in vitro to chloramphenicol, doxycycline or flnoroqninolones, bnt clinical results with these drugs have been variable. 

Hochlowski, J. E., Mullally, M. M, Spanton, S G., Whittem, D. N., Hill, P., and McAlpine, J. B. (1993) 5-N-Acetylardeemm, a novel heterocyclic compound which reverses multiple drug resistance in tumor cells II. Isolation and elucidation of the structure of 5-N-acetylardeemin and two congeners. J Antibiotics 46,380-386. 

SA stimulates expression of the marRAB operon (multiple-antibiotic-resistance), which suggests a role for the mar locus in PAR (phenotypic antibiotic resistance). However, since SA leads to increased drug resistance even in mar-inactivated strains, SA must also be able to induce drug resistance through a mar-independent pathway. 

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