Bacterial Phenotypes Refractory to Antibiotic-Mediated Killing: Mechanisms and Mitigation
Alex J. O'Neill
from: Emerging Trends in Antibacterial Discovery: Answering the Call to Arms (Edited by: Alita A. Miller and Paul F. Miller). Caister Academic Press, U.K. (2011)
Antibiotic resistance is conferred by heritable genetic determinants that enable a bacterium to grow and cause disease in the presence of therapeutically-achievable concentrations of the corresponding antibiotic. However, bacteria may also become refractory to the killing action of antibacterial agents in ways that do not fit this definition, and which are collectively referred to here as 'antibiotic survival'. These phenomena, which include drug indifference, tolerance, persistence, and the recalcitrance of biofilms to antibacterial agents, are believed to play a central role in antibacterial treatment failure. In addition, they can extend the duration of treatment required to resolve bacterial infections, and facilitate the emergence of acquired antibiotic resistance. This chapter will provide an overview of the different types of antibiotic survival, and will discuss chemotherapeutic approaches to minimising or overcoming the problems that they present to effective antibacterial treatment read more ...