Antibiotics and Antimicrobial Resistance

  1. Understanding Antimicrobial Resistance
    1. Resistance Definitions and Concepts
      1. Clinical Resistance
        1. Treatment failure correlation
          1. Breakpoint determinations
          2. Microbiological Resistance
            1. Laboratory-defined resistance
              1. MIC interpretations
              2. Minimum Inhibitory Concentration
                1. Testing methodologies
                  1. Interpretation standards
                    1. Quality control measures
                  2. Types of Bacterial Resistance
                    1. Intrinsic Resistance
                      1. Species-specific characteristics
                        1. Natural impermeability
                          1. Inherent enzyme production
                          2. Acquired Resistance
                            1. Mutation-based resistance
                              1. Horizontally acquired resistance
                                1. Selection pressure effects
                              2. Genetic Basis of Resistance
                                1. Spontaneous Mutations
                                  1. Point mutation mechanisms
                                    1. Target site alterations
                                      1. Regulatory gene changes
                                        1. Mutation rates and frequencies
                                        2. Horizontal Gene Transfer
                                          1. Transformation Mechanisms
                                            1. Competence development
                                              1. DNA uptake processes
                                                1. Integration mechanisms
                                                2. Transduction Mechanisms
                                                  1. Generalized transduction
                                                    1. Specialized transduction
                                                      1. Bacteriophage roles
                                                      2. Conjugation Mechanisms
                                                        1. Pilus formation
                                                          1. DNA transfer processes
                                                            1. Plasmid mobilization
                                                        2. Mobile Genetic Elements
                                                          1. Plasmids
                                                            1. Replication mechanisms
                                                              1. Incompatibility groups
                                                                1. Resistance gene clustering
                                                                2. Transposons
                                                                  1. Composite transposons
                                                                    1. Tn family elements
                                                                      1. Insertion mechanisms
                                                                      2. Integrons
                                                                        1. Gene cassette systems
                                                                          1. Integration mechanisms
                                                                            1. Class 1 integrons

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                                                                        2. Antibiotic Classification and Mechanisms of Action

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                                                                        4. Biochemical Mechanisms of Resistance