Table 1.
Mechanism of action and antibiotics affected by common MDR bacteria.
| MDR type | WHO priority category | Mechanism of resistance | ABs class | Reference |
|---|---|---|---|---|
| Pseudomonas aeruginosa | Critical | Efflux pump (MexAB-OprM) | β-Lactams and penem groups of ABs | [60] |
| Enzyme inactivation (β-lactamase) | ||||
| Alteration of membrane permeability | ||||
|
| ||||
| Acinetobacter baumannii | Critical | Enzyme inactivation (aminoglycoside-modifying enzyme) | β-LactamsAminoglycosides | [61] |
| Efflux pump | ||||
| Change membrane permeability | ||||
|
| ||||
| Klebsiella pneumoniae | Medium | Alteration of target site | 3rd generation cephalosporins β-Lactams Carbapenem | [62] |
| Enzyme inactivation (β-lactamase) | ||||
| Efflux pump | ||||
| Alteration of membrane permeability | ||||
|
| ||||
| MRSA, VRSA, VISA | High | Binding site alteration Mutation in genes involved in cell wall synthesisEfflux pump (NorA) | Methicillin | [7] |
| Oxacillin | ||||
| Vancomycin | ||||
| Penicillin | ||||
| Cephalosporins | ||||
| Carbapenem | ||||
|
| ||||
| VRE | High | Alteration of target site | Most ABs | [63] |
| Vancomycin | ||||
| Daptomycin | ||||
| Linezolid | ||||
|
| ||||
| CRE | Critical | Enzyme inactivation(β-lactamase and carbapenemase) | β-Lactams | [64] |
| Most ABs | ||||
| Carbapenem | ||||
|
| ||||
| Escherichia coli | Critical | Efflux pump (AcrAB-TolC) | Trimethoprim, amoxicillin, gentamycin, tetracycline | [65] |
|
| ||||
| Helicobacter pylori | High | Mutation in the domain V of 23S rRNA gene of the bacteria | Clarithromycin | [46] |
MRSA: methicillin-resistant staphylococcus aureus, VRSA: vancomycin-resistant staphylococcus aureus, VISA: vancomycin intermediate staphylococcus aureus, VRE: vancomycin-resistant enterococci, and CRE: carbapenem-resistant Enterobacteriaceae.