Molecular Mechanisms of Antibiotic Resistance Expressed by the Pathogenic Neisseria
William M. Shafer, Jason P. Folster and Robert A. Nicholas
from: Neisseria: Molecular Mechanisms of Pathogenesis (Edited by: Caroline Genco and Lee Wetzler). Caister Academic Press, U.K. (2010)
Diseases caused by the pathogenic Neisseria (N. gonorrhoeae and N. meningitidis) have been successfully treated with antibiotics for the past 70 years. However, a disturbing trend worldwide is the increasing prevalence of strains with resistance to inexpensive and widely available antibiotics (e.g., penicillin, tetracycline and ciprofloxacin) and the emergence of strains exhibiting decreased susceptibility to effective antibiotics that are expensive and not always available (e.g. third-generation cephalosporins and the newer macrolides). Given the global nature of gonococcal and meningococcal diseases, the worldwide distribution of antibiotics, differing social practices in controlling and monitoring antibiotic availability, and geographical differences in treatment regimens, it is likely that the global problem of antibiotic resistance will continue (and worsen) in the foreseeable future. By understanding the mechanisms of antibiotic resistance in gonococci and meningococci, resistance to antibiotics currently in clinical practice can be anticipated and the design of novel antimicrobials to circumvent this problem can be undertaken more rationally. Herein, we review the genetic and physiologic basis by which the pathogenic Neisseria developed resistance to historically important antibiotics and how resistance to newer antibiotics is emerging read more ...