Antimicrobial resistance is a prevailing issue since the discovery of the first antibiotic Penicillin in 1928. There are 5 mechanisms which allow resistance to impede new antibiotic development for the last 29 years (WHO, 2016) consisting of mutations in target genes, enzymatic resistance, latency, antibiotic efflux and non-specific mutations. Latency and antibiotic efflux are some of the most detrimental mechanisms on antimicrobial resistance. Latent tuberculosis is a prominent example, consistently a focus globally with a third of the world’s population infected with it (Maitra, et al., …show more content…
In order for bacteria to protect themselves their genes are involved in stopping the antibiotic from accessing its target; these genes are called target access genes. Genes are also involved in where the antibiotic target is positioned which goes hand in hand with the target access genes in protecting the bacteria. A third way genes are protecting the bacteria is through mutations which use e.g. efflux pumps, these are target protection mutations. These are only three mutations which protect bacteria collectively and successfully which creates multidrug resistant bacteria. An example of mutations in action is P. aeruginosa having the ability to bypass β lactam antibiotics because it has β lactamase and the MDR system MexAB-OprM (Martinez & Baquero, …show more content…
Resistance can start with single large-step mutations where the drugs target may be transposed. This can go a step further and lead to a multistep pattern of resistance. When enough mutations occur a highly resistant organism forms which links to β lactamases and tuberculosis’s ability to be multi resistant and the extensive treatment people need to receive because of the multi resistance they have. Chromosomal mutations in genes coding for β lactamase can result in overproduction of the enzyme and therefore leads to resistance. This links to the enzymatic resistance mechanism mentioned in the introduction. β lactamases are now multi resistant particularly the TEM β lactamases to cephalosporins and other antibiotics with a β lactam ring (Greenwood, et al.,