Molecular Mechanisms of Bacterial Antibiotic Resistance

Antibiotic resistance is a prevalent threat to global health and humankind, guided by varied bacterial adaptations that reduce the efficiency of currently available and in-use antibacterial drugs. In 2021, we estimated 4.71 million deaths were associated with bacterial AMR, including 1.14 million deaths attributable to bacterial AMR. Trends in AMR mortality over the past 31 years varied substantially by age and location. From 1990 to 2021, deaths from AMR decreased by more than 50% among children younger than 5 years, yet increased by over 80% for adults 70 years and older. In this mini review, we present an effective interpretation of the major molecular systems of resistance, including target alteration, drug inactivation mechanisms, horizontal gene transfer, clinical implications, and strategic solutions. Apart from these classical mechanisms, we also acknowledge adaptive physiological pathways, similar to biofilm formation and persistence, that contribute to antimicrobial treatment failures. Comprehending these mechanisms is crucial for conducting an improvement of modern antibiotics and stewardship programs.